Angielia Lee Brooks, LCSW

Individual provider Active NPI Clinical Social Worker · Lebanon, IN

NPI 1568926558 · NPPES record last updated Jan 24, 2019

Key facts

NPI
1568926558
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34008397A (IN)
Practice address
610 N Lebanon St
Lebanon, IN 46052-1716
Phone
(765) 680-0071
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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 participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Treatment and Recovery Center, LLC Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008397A IN Yes

Addresses

Primary practice location

610 N Lebanon St
Lebanon, IN 46052-1716

Mailing address

610 N Lebanon St
Lebanon, IN 46052-1716
Phone (765) 680-0071

Other names

  • Angielia Mix Former name

Other providers in Lebanon, IN

All providers in Lebanon, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.