Active NPI
Jeffrey Brooks, MA,LLPC,LAD,CAC-I
- Counselor
- Detroit, MI
National Provider Identifier
1508968462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 620390564853
- Practice address
- 150 W Hildale
Detroit, MI 48203-1948 - Phone
- (313) 893-5034
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 620390564853 | MI | Primary |
Addresses
Primary practice location
150 W Hildale
Detroit, MI 48203-1948
Mailing address
1400 E 12 Mile Rd
Madison Heights, MI 48071-2651
Phone (248) 547-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 631090 | Medicaid | MI |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 620390564853 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204848000000",
"number": "1508968462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E 12 MILE RD",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480712651",
"telephone_number": "248-547-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 W HILDALE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482031948",
"telephone_number": "313-893-5034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "MA,LLPC,LAD,CAC-I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2008-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "620390564853",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "631090",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.