Mary Imani Brooks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW006414 Issued in GA

Practice address

700 S Fairfield Dr
Peachtree City, GA 30269

Phone

(662) 341-2694

NPI assigned

Nov 29, 2017

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

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Interventional Psychiatry Consultants

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1033894274
  NPD (past)

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1346754215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S FAIRFIELD DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693922",
            "telephone_number": "662-341-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S FAIRFIELD DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "30269",
            "telephone_number": "662-341-2694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 Hollywood Blvd Fl 215",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330216515",
            "country_code": "US",
            "telephone_number": "662-341-2694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3197 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "303445455",
            "country_code": "US",
            "telephone_number": "404-551-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MARY",
        "middle_name": "IMANI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05909900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800895-SUPV",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2144",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lei-Ann Bridges
• Henry B. Briggs III, DMD
• Myra Briggs
• Kayla Nichole Brook, PT
• Jillian Brooks, BCBA
• Preston Brooks, HHP
• Robert S Brooks, D.D.S.
• Sharon Wallace Brooks, LCSW
• Emma Brosnan, BCBA
• Alison Hammonds Brown, LMSW

• Clinical Social Worker in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.