Provider Demographics
NPI:1184962763
Name:BROOKS, YVONNE ROCHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:ROCHELLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:ROCHELLE
Other - Last Name:MCCLEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:319 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2857
Mailing Address - Country:US
Mailing Address - Phone:269-591-0117
Mailing Address - Fax:
Practice Address - Street 1:319 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2857
Practice Address - Country:US
Practice Address - Phone:269-591-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010822131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical