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Individual

BROOKE GADDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
320 COMMERCE AVE SW, GRAND RAPIDS, MI 49503-4101
(616) 258-7599
(616) 222-4571
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 258-7599
(616) 222-4571

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
6801095704
MI
1041C0700X
Clinical Social Worker
Primary
6801095704
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174941652
MI
Enumeration date
04/02/2014
Last updated
03/26/2025
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