Provider Demographics
NPI:1952823015
Name:BROOKS, MELVIN LOUIS III
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:LOUIS
Last Name:BROOKS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3946 MEADOWBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4437
Mailing Address - Country:US
Mailing Address - Phone:216-856-2681
Mailing Address - Fax:
Practice Address - Street 1:3100 E 45TH PLACE
Practice Address - Street 2:212
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127
Practice Address - Country:US
Practice Address - Phone:216-341-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical