Provider Demographics
NPI:1669098844
Name:BROOKS, JAMES EARL I (MS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EARL
Last Name:BROOKS
Suffix:I
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2648
Mailing Address - Country:US
Mailing Address - Phone:608-361-7200
Mailing Address - Fax:608-361-7201
Practice Address - Street 1:523 CLARK ST
Practice Address - Street 2:
Practice Address - City:SOUTH BELOIT
Practice Address - State:IL
Practice Address - Zip Code:61080-1317
Practice Address - Country:US
Practice Address - Phone:779-770-9713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)