Beverly Dawn Brooks, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002831 Issued in GA

Practice address

660 Village Trce NE BLDG 18
Paper Mill Village Office Park
Marietta, GA 30067-4081

Phone

(678) 267-6054

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 1, 2016 through Sep 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1326250978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 VILLAGE TRCE NE BLDG 18",
            "address_2": "PAPER MILL VILLAGE OFFICE PARK",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674081",
            "telephone_number": "678-267-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 VILLAGE TRCE NE BLDG 18",
            "address_2": "PAPER MILL VILLAGE OFFICE PARK",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674081",
            "telephone_number": "678-267-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BEVERLY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002831",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1844",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "GA",
            "license": "PSY002831",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NC",
            "license": "1844",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "PSY002831",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imogene Hays Brodsky, LCSW
• Lorraine Brogdon-Harris, LPC
• Abigail Broms, MA
• Kaylee Marie Bronson, NP
• Yamily Brooke, LSW
• Brandon Edwin Brooks, PHARM.D
• Grace Brooks
• James G Brooks, LDO
• Lisa Renee Brooks, LMSW
• Onthatile Angel Brooks, LMFT

• Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.