Active NPI
Lee Michelle Brooks, LCSW
- Clinical Social Worker
- Tifton, GA
National Provider Identifier
1356778435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004972
- Practice address
- 907 18TH St E
Suite 150
Tifton, GA 31794-3643 - Phone
- (229) 353-3422
- NPI assigned
- Oct 3, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 004972 | GA | Primary |
Addresses
Primary practice location
907 18TH St E
Suite 150
Tifton, GA 31794-3643
Mailing address
5427 Woodrow LN
Hahira, GA 31632-2551
Phone (229) 794-1748
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
| License | State | Type | Specialty |
|---|---|---|---|
| 004972 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1356778435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5427 WOODROW LN",
"city": "HAHIRA",
"state": "GA",
"postal_code": "316322551",
"telephone_number": "229-794-1748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 18TH ST E",
"address_2": "SUITE 150",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943643",
"telephone_number": "229-353-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "LEE",
"middle_name": "MICHELLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-03",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "004972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.