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Individual
MYRA J BROOKS
Active
Individual
MYRA J BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LPC,LCSW,SAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15626-132
WI
101YP2500X
Professional Counselor
3808-125
WI
101YP2500X
Professional Counselor
6401009846
MI
1041C0700X
Clinical Social Worker
Primary
68010933800
MI
1041C0700X
Clinical Social Worker
8130-123
WI
Other
Enumeration date
09/30/2011
Last updated
05/25/2021
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