Individual provider Active NPI

Tenesha Brooks, MSW, LICSW, LCSW

  • Social Worker
  • Somerville, MA
National Provider Identifier
1598098311
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
111 South St
Somerville, MA 02143-4297
Phone
(617) 284-5130
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

111 South St
Somerville, MA 02143-4297

Mailing address

61 N Plains Industrial Rd # 188
Wallingford, CT 06492-5841
Phone (203) 491-0650

Other names 1

  • Tenesha Patricia Patrick Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks Psychological Services, LLC Current Accepting new patients
Riverside Community Care, Inc. PastSince Jan 6, 2017 Accepting new patients

Locations

61 N Plains Industrial Rd
Wallingford, CT 06492
Phone (203) 974-2829

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1598098311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 N PLAINS INDUSTRIAL RD # 188",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925841",
            "telephone_number": "203-491-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434297",
            "telephone_number": "617-284-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TENESHA",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2020-10-12",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TENESHA",
            "last_name": "PATRICK",
            "middle_name": "PATRICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.