Walter Brooks, PHD, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC003956 Issued in GA

Practice address

159 Forsyth St SW
Atlanta, GA 30303-3634

Phone

(404) 523-4599

Fax

(404) 586-0645

NPI assigned

Feb 22, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Wholeness Within LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Decatur, GA
  • NPI 1255042982
  Medicare reassignment NPD Authorized official
• Tangu, Inc

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1336449537
  NPD (past) Authorized official

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1669745675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55469",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303085469",
            "telephone_number": "404-523-4599",
            "fax_number": "404-586-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 FORSYTH ST SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033634",
            "telephone_number": "404-523-4599",
            "fax_number": "404-586-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "WALTER",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-22",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "GA",
            "license": "1091587",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "GA",
            "license": "LPC003956",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE PROFESSIONAL COUNSELING",
            "identifier": "LPC003956",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "033128490",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHD HUMAN SERVICES PROFESSIONAL COUNSELING SPECIALIZATION",
            "identifier": "1091587",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Marie Brooks, D.C.
• Shaliyah N Brooks
• Stacie Andrea Brooks
• Tara Brooks
• Taylor Brooks
• Walter Scott Brooks, MD
• Caroline Broom
• Chennel Broom
• S Broom
• Nevaeh Faith Broome

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.