Individual
MRS. ALICE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
31 ASHFORD DR, AVON, CT 06001-4552
(860) 205-1829
Mailing address
31 ASHFORD DR, AVON, CT 06001-4552
(860) 205-1829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002890
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079524
MHN PROVIDER NUMBER
CT
01
—
140002890 CT01
BLUE CROSS PROVIDER
CT
01
—
P3203033
OXFORD PROVIDER NUMBER
CT
Enumeration date
08/15/2006
Last updated
03/23/2023
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