Brooke Parker Wilson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121459 Issued in MA

Practice address

200 Springs Road
Bedford, MA 01730-1114

Phone

(781) 687-2000

NPI assigned

Sep 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1285459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1598074502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TAFT ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452440",
            "telephone_number": "781-883-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGS ROAD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Lafayette St Ste 1-E",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019704721",
            "country_code": "US",
            "telephone_number": "781-990-6773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BROOKE",
        "middle_name": "PARKER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-26",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Whelan
• Brandice White
• Valene Augusta Whittaker, PH.D.
• Briana Marie Wiley, LCSW
• Tanya Wiley, RN
• Carly Kristen Wilson, LICSW
• Pamela Joy Wilson, MSW LICSW
• Donee Lee Wong, O.D.
• Joanna Wong, PHARM.D.
• Danielle Wood, CTRS

• Clinical Social Worker in Bedford, MA
• Providers in Bedford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.