Provider Demographics
NPI:1932450129
Name:WEBB-GENNUSA, BROOKE RENEE (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:RENEE
Last Name:WEBB-GENNUSA
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:R
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:4312 SW STONE AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66610-2321
Mailing Address - Country:US
Mailing Address - Phone:785-430-3152
Mailing Address - Fax:
Practice Address - Street 1:4505 NW FIELDING RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66618-2651
Practice Address - Country:US
Practice Address - Phone:785-270-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical