Jessica M Brooks, PHD, CRC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3799 Issued in WI

Practice address

625 W Washington Ave
Madison, WI 53703-2637

Phone

(608) 280-2700

NPI assigned

May 17, 2007

Last updated

Dec 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Neurodiversity & Disability Affirming Therapy LTD.

  • Psychologist
  • Madison, WI
  • NPI 1194587923
  Medicare reassignment Authorized official
• Greenbush Psychotherapy LLC

  • Psychologist
  • Madison, WI
  • NPI 1891568002

  Counselor

  NPD Authorized official

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1346457231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S RANDALL AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151653",
            "telephone_number": "608-963-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-280-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "541 S Randall Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151653",
            "country_code": "US",
            "telephone_number": "608-963-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37999",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023251",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Notapplicable",
            "affiliation": "N",
            "address_1": "156 W 56th St Ste 1804",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100193878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ebonie Brooks
• Emma Lynn Brooks, PT
• Erin Grace Brooks, M.D.
• Grant Brooks
• Jaden Brooks, MD
• Maanasi Lanikki Brooks, N/A
• Margaret A. Brooks, M.D.
• Nathaniel P. Brooks, M.D.
• Robert J Brooks, DDS
• Kari Brosius, RN

• Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.