Beata Marianna Brooks, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104475 Issued in TX

Practice address

2205 Hurley Ave
Fort Worth, TX 76110-1829

Phone

(817) 888-0422

Fax

(817) 924-7658

NPI assigned

Dec 7, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Beata Marianna Wazny Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1184952970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 HURLEY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101829",
            "telephone_number": "817-888-0442",
            "fax_number": "817-924-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 HURLEY AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101829",
            "telephone_number": "817-888-0422",
            "fax_number": "817-924-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BEATA",
        "middle_name": "MARIANNA",
        "name_prefix": "Ms.",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "805T852",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208626601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEATA",
            "last_name": "WAZNY",
            "middle_name": "MARIANNA",
            "prefix": "MS.",
            "credential": "CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooks Memorial Clinic Fort Worth
• Brooks Psychological, PLLC (Peaceful Brooks Wellness Group)
• Brooks Surgery Clinic, PLLC
• Amy E Brooks, RD
• April R Brooks, PSY.D.
• Hunter Brooks
• Jennifer C Brooks, M.D.
• John Zachary Brooks, AU.D.
• Karen June Brooks, LCSW
• Kate Ashton Brooks, DO

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.