Kawanna Brooks
Individual provider Active NPI Social Worker · Watseka, IL
NPI 1790346567 · NPPES record last updated Jun 24, 2019
Key facts
- NPI
- 1790346567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 323 W Mulberry St
Watseka, IL 60970-1568 - Phone
- (815) 432-5241
- NPI assigned
- Jun 24, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
323 W Mulberry St
Watseka, IL 60970-1568
Mailing address
PO Box 322
Watseka, IL 60970-0322
Phone (815) 432-5241
Other providers in Watseka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.