Active NPI
Brooklyn Jo Dick, LSW
- Social Worker
- Indianapolis, IN
National Provider Identifier
1760164941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 33011492A
- Practice address
- 9434 Haddington Dr W
Indianapolis, IN 46256-1147 - Phone
- (317) 605-0356
- NPI assigned
- Aug 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 33011492A | IN | Primary |
Addresses
Primary practice location
9434 Haddington Dr W
Indianapolis, IN 46256-1147
Mailing address
9434 Haddington Dr W
Indianapolis, IN 46256-1147
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33011492A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1760164941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9434 HADDINGTON DR W",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9434 HADDINGTON DR W",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561147",
"telephone_number": "317-605-0356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICK",
"first_name": "BROOKLYN",
"middle_name": "JO",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2023-08-07",
"certification_date": "2023-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "33011492A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.