Individual provider Active NPI

Judith L Brooks

  • Addiction (Substance Use Disorder) Counselor
  • Bronx, NY
National Provider Identifier
1386910925
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11516 Issued in NY
Practice address
5676 Riverdale Ave Ste 202
Bronx, NY 10471-2100
Phone
(718) 796-5300
Fax
(718) 548-1161
NPI assigned
Mar 28, 2012
Last updated
Mar 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11516 NY Primary

Addresses

Primary practice location

5676 Riverdale Ave Ste 202
Bronx, NY 10471-2100

Mailing address

5676 Riverdale Ave Ste 202
Bronx, NY 10471-2100
Phone (718) 796-5300

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11516NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1386910925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE STE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712100",
            "telephone_number": "718-796-5300",
            "fax_number": "718-548-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE STE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712100",
            "telephone_number": "718-796-5300",
            "fax_number": "718-548-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JUDITH",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.