Individual provider Active NPI

Joel Sidney Brooks, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1477627859
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 1761 Issued in FL
Practice address
3500 E Fletcher Ave
Suite 129
Tampa, FL 33613-4708
Phone
(813) 978-3960
Fax
(813) 978-0475
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 1761 FL Primary

Addresses

Primary practice location

3500 E Fletcher Ave
Suite 129
Tampa, FL 33613-4708

Mailing address

6237 Eaglebrook Ave
Tampa, FL 33625-1518
Phone (813) 978-3960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000396 FL Practitioner - Clinical Social Worker 9739160185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3500 E Fletcher Ave
Suite 501
Tampa, FL 33613-4792
Phone (813) 978-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Brooks Counseling, Inc Clinical CurrentSince Jun 11, 2011 Accepting new patients
Tampa Jewish Family Services Inc Past Accepting new patients
Trillium Medical Group of Florida Past Accepting new patients
Baycare Behavioral Health Centers, Inc Past Accepting new patients
Clinical Service Associates Inc Clinical Past Accepting new patients

Locations

3500 E Fletcher Ave
Ste 129
Tampa, FL 33613
Phone (813) 340-3577

3500 E Fletcher Ave
Ste 501
Tampa, FL 33613
Phone (813) 978-3960

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477627859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6237 EAGLEBROOK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336251518",
            "telephone_number": "813-978-3960",
            "fax_number": "813-978-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 E FLETCHER AVE",
            "address_2": "SUITE 129",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134708",
            "telephone_number": "813-978-3960",
            "fax_number": "813-978-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JOEL",
        "middle_name": "SIDNEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 1761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.