Etta C Brooks, LISW, LICDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

I4270 Issued in OH

Practice address

3469 Fortuna Dr
Akron, OH 44312-5281

Phone

(330) 644-3469

Fax

(330) 644-8519

NPI assigned

Jul 19, 2005

Sex

Female

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Akron Family Institute, Inc.Group PAC ID 1658437389, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Akron Family Institute, Inc.

  • Counseling Psychologist
  • Akron, OH
  • NPI 1912174319
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104825470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 FORTUNA DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443125281",
            "telephone_number": "330-644-3469",
            "fax_number": "330-644-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 FORTUNA DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443125281",
            "telephone_number": "330-644-3469",
            "fax_number": "330-644-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ETTA",
        "middle_name": "C",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I4270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookdale Place of Bath LLC (Brookdale Bath)
• Angela Nicole Brooks, LPCC
• Breeonie D Brooks
• Ciarra Brooks
• Cynthia Marie Brooks
• Gail D Brooks
• Glenisha Ann Brooks
• Jermaine Brooks
• Katika Brooks
• Marcella Brooks

• Mental Health Counselor in Akron, OH
• Providers in Akron, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.