Brooke Lee Altonaga, LCSW

Individual provider Active NPI Clinical Social Worker · Rockledge, FL

NPI 1386908309 · NPPES record last updated Feb 11, 2022

Key facts

NPI
1386908309
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW12031 (FL)
Practice address
500 Barton Blvd Ste 7
Rockledge, FL 32955-3172
Phone
(321) 504-3888
Fax
(321) 504-3462
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Resource Center Inc (14 clinicians)

Practice addresses (Care Compare)

3333 W 20TH St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240620004034 FL Practitioner - Clinical Social Worker 2567905334 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc Current
since May 15, 2024
Accepting new patients
Mental Health Resource Center Inc Current
since Jul 4, 2021
Accepting new patients

Locations

11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100

3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364

500 Barton Blvd
Ste 7
Rockledge, FL 32955
Phone (321) 504-3888

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12031 FL Yes
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

500 Barton Blvd Ste 7
Rockledge, FL 32955-3172

Mailing address

500 Barton Blvd Ste 7
Rockledge, FL 32955-3172
Phone (321) 504-3888

Other names

  • Brooke Lajoie La Former name

Other providers in Rockledge, FL

All providers in Rockledge, FL · Clinical Social Worker in Florida

Sources for this page

Verify at the official NPI Registry.