Randolph Brooks, PH.D.

Primary specialty

CounselorTaxonomy code 101Y00000X

License

3400 Issued in CT

Practice address

40 Connecticut Ave
Norwich, CT 06360-1502

Phone

(860) 889-7274

NPI assigned

Mar 13, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013410315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CONNECTICUT AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063601502",
            "telephone_number": "860-889-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CONNECTICUT AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063601502",
            "telephone_number": "860-889-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 N Main St Ste 212",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061071941",
            "country_code": "US",
            "telephone_number": "860-889-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "RANDOLPH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "3400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kie'Andra Britto-Sebastian
• Samantha Brodnicki, RPH
• Marygrace Brogioli, CPNP-PC
• Kaz Tamar Brolin
• John Brooks, LCSW
• Marissa Brouillard
• Manson Reuben Brow Jr.
• Vladimir A Brown-Zheltkov, M.D.
• Kaila Brown, LCSW
• Leslie N Brown, P.A.

• Counselor in Norwich, CT
• Providers in Norwich, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.