Provider Demographics
NPI:1760691091
Name:BROOKMAN, CATHY SIMMONS (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:SIMMONS
Last Name:BROOKMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 NEWBURG AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5109
Mailing Address - Country:US
Mailing Address - Phone:410-747-4545
Mailing Address - Fax:
Practice Address - Street 1:205 E JOPPA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3260
Practice Address - Country:US
Practice Address - Phone:410-296-3448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02881103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling