Everest Cameron Brooks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7364-123 Issued in WI

Practice address

12970 W Bluemound Rd
Suite 105
Elm Grove, WI 53122-2607

Phone

(262) 787-2907

NPI assigned

Aug 1, 2006

Last updated

Oct 15, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

University of Wisconsin School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Clinical Services IncGroup PAC ID 0244124899, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Affiliated Clinical Services Inc

  • Multi-Specialty Clinic/Center
  • West Bend, WI
  • NPI 1851473698
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1184631624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12970 W BLUEMOUND RD",
            "address_2": "SUITE 105",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222607",
            "telephone_number": "262-787-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12970 W BLUEMOUND RD",
            "address_2": "SUITE 105",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222607",
            "telephone_number": "262-787-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "EVEREST",
        "middle_name": "CAMERON",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7364-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43722400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elissa Box, LPC
• Kimberly Brandhagen, APSW, SAC-IT
• Russell Wieston Brethauer, PSYD.
• Bright Day Wellness, LLC
• James Joseph Brinks, HIS
• Karin Lynn Buckholdt, PT
• Rene Ann Burgoyne, MS, ATRL-BC
• Marcy Cepulis, LMT
• Alexis Chapman
• Christos Counseling

• Clinical Social Worker in Elm Grove, WI
• Providers in Elm Grove, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.