Individual
BROOKE ALSTON JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
302 WASHINGTON AVE SW STE B, ROANOKE, VA 24016-4312
(540) 524-9918
(540) 215-7226
Mailing address
1140 BRAMLETT RD, MONETA, VA 24121-6246
(540) 525-0908
(540) 215-7226
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012752
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601518555
—
VA
Enumeration date
03/25/2021
Last updated
10/23/2021
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