Tiffany Deloatch Brooks, MSW, LCSWA

Primary specialty

Social WorkerTaxonomy code 104100000X

License

P016129 Issued in NC

Practice address

622 Roanoke Ave Ste C
Roanoke Rapid, NC 27870-2740

Phone

(252) 541-3833

NPI assigned

Mar 7, 2022

Last updated

Mar 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Tiffany Nicole Deloatch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holt Assessment Services

  • Community/Behavioral Health Agency
  • Roanoke Rapids, NC
  • NPI 1831721596
  NPD

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1669129938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 ABBITT RD",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278929660",
            "telephone_number": "757-707-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 ROANOKE AVE STE C",
            "city": "ROANOKE RAPID",
            "state": "NC",
            "postal_code": "278702740",
            "telephone_number": "252-541-3833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Smith Church Rd",
            "address_purpose": "LOCATION",
            "city": "Roanoke Rapids",
            "state": "NC",
            "postal_code": "278704913",
            "country_code": "US",
            "telephone_number": "252-410-0548",
            "fax_number": "252-541-3832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TIFFANY",
        "middle_name": "DELOATCH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P016129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "DELOATCH",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "MSW, LCSWA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Graylon W Bailey, DMD

• Social Worker in Roanoke Rapid, NC
• Providers in Roanoke Rapid, NC by specialty
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.