Provider Demographics
NPI:1790366631
Name:BROOKS, HOLLY ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANNE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JENKINS RANCH RD UNIT E1
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-9473
Mailing Address - Country:US
Mailing Address - Phone:970-442-3830
Mailing Address - Fax:
Practice Address - Street 1:100 JENKINS RANCH RD UNIT E1
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-9473
Practice Address - Country:US
Practice Address - Phone:970-442-3830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSCW.0000001089104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker