Individual provider Active NPI

Lakisha Yvette Brooks, LCSW

  • Clinical Social Worker
  • Warner Robins, GA
National Provider Identifier
1659480168
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004558 Issued in GA
Practice address
104 Whiting Way Ste 110
Warner Robins, GA 31088-8054
Phone
(478) 220-9865
Fax
(478) 220-7491
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11294 MD
Clinical Social Worker 1041C0700X 5001 TX
Clinical Social Worker 1041C0700X CSW004558 GA Primary

Addresses

Primary practice location

104 Whiting Way Ste 110
Warner Robins, GA 31088-8054

Mailing address

1412A Russell Pkwy # 219
Warner Robins, GA 31088-5583
Phone (478) 220-9865

Other practice location 1

121 Carl Vinson Pkwy
Warner Robins, GA 31088-5817
Phone (478) 922-2365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20111228000178 GA Practitioner - Clinical Social Worker 6406817014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

104 Whiting Way
Suite 110
Warner Robins, GA 31088-8054
Phone (478) 220-9865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004558GAMDProfessional Counselor
CSW004558GAMDClinical Social Worker
5001TXMDMarriage & Family Therapist
11294MDMDPharmacist
50001TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyb Counseling Services Clinical CurrentSince May 20, 2020 Accepting new patients
Kidney Medical Associates Inc PastSince Sep 1, 2006 Accepting new patients
St. Cyr, LLC Past Accepting new patients
Bleach and Associates, LLC Clinical Past Accepting new patients
Diversified Counseling Services, LLC PastSince Feb 20, 2017 Accepting new patients

Locations

104 Whiting Way
Ste 110
Warner Robins, GA 31088
Phone (478) 220-9865

1412 Russell Pkwy
Ste A
Warner Robins, GA 31088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18593/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1659480168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412A RUSSELL PKWY # 219",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885583",
            "telephone_number": "478-220-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WHITING WAY STE 110",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888054",
            "telephone_number": "478-220-9865",
            "fax_number": "478-220-7491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Carl Vinson Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310885817",
            "country_code": "US",
            "telephone_number": "478-922-2365",
            "fax_number": "478-922-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "LAKISHA",
        "middle_name": "YVETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11294",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "5001",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.