Provider Demographics
NPI:1790208445
Name:FOSTER, BROOKSLEY BROWN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:BROOKSLEY
Middle Name:BROWN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 NE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:OK
Mailing Address - Zip Code:73121-2013
Mailing Address - Country:US
Mailing Address - Phone:405-820-7495
Mailing Address - Fax:
Practice Address - Street 1:3080 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4323
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5988-POtherLMSW-P