Individual provider Active NPI

Andre Brooks

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1225610876
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Practice address
3610 Howard Park Ave
Baltimore, MD 21207-7153
Phone
(443) 453-1460
NPI assigned
Apr 23, 2021
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3610 Howard Park Ave
Baltimore, MD 21207-7153

Mailing address

3610 Howard Park Ave
Baltimore, MD 21207-7153
Phone (443) 453-1460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1225610876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 HOWARD PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077153",
            "telephone_number": "443-453-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 HOWARD PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077153",
            "telephone_number": "443-453-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.