Provider Demographics
NPI:1861642266
Name:BROOKS-KEY, LATOYA (PHD, MSW, MA, LCSW,)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:BROOKS-KEY
Suffix:
Gender:F
Credentials:PHD, MSW, MA, LCSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 HARD SCRABBLE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9499
Mailing Address - Country:US
Mailing Address - Phone:917-676-6438
Mailing Address - Fax:
Practice Address - Street 1:4611 HARD SCRABBLE RD STE 109
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9499
Practice Address - Country:US
Practice Address - Phone:917-676-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSW13225CP1041C0700X
PACW0161081041C0700X
NCC0112231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical