Provider Demographics
NPI:1376386342
Name:ROOKS, REGGIE (ADT)
Entity type:Individual
Prefix:
First Name:REGGIE
Middle Name:
Last Name:ROOKS
Suffix:
Gender:M
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W MADISON ST STE 11
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2313
Mailing Address - Country:US
Mailing Address - Phone:443-961-3050
Mailing Address - Fax:443-957-9485
Practice Address - Street 1:309 CATHEDRAL ST STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4430
Practice Address - Country:US
Practice Address - Phone:443-961-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT3418101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)