Individual provider Active NPI

Christina Brooke, LCSW

  • Clinical Social Worker
  • Plano, TX
National Provider Identifier
1356712954
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60076 Issued in TX
Practice address
101 E Park Blvd Ste 1160
Plano, TX 75074-8890
Phone
(469) 360-3177
NPI assigned
Oct 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121295 MA
Clinical Social Worker 1041C0700X 60076 TX Primary

Addresses

Primary practice location

101 E Park Blvd Ste 1160
Plano, TX 75074-8890

Mailing address

1721 E Belt Line Rd Apt 1325
Coppell, TX 75019-9619
Phone (469) 360-3177

Other practice location 1

231 Forest St
Campus Box 155
Babson Park, MA 02457
Phone (469) 360-3177

Other practice location 2

9741 Preston Rd Ste 208
Frisco, TX 75033-2554
Phone (469) 360-3177

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
121295MAMDClinical Social Worker
60076TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1356712954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 E BELT LINE RD APT 1325",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199619",
            "telephone_number": "469-360-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E PARK BLVD STE 1160",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748890",
            "telephone_number": "469-360-3177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Forest St",
            "address_2": "Campus Box 155",
            "address_purpose": "LOCATION",
            "city": "Babson Park",
            "state": "MA",
            "postal_code": "02457",
            "country_code": "US",
            "telephone_number": "469-360-3177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9741 Preston Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750332554",
            "country_code": "US",
            "telephone_number": "469-360-3177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121295",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.