Individual provider Active NPI

Charles Edward Brooks, CAP

  • Addiction (Substance Use Disorder) Counselor
  • Palm Springs, FL
National Provider Identifier
1861830085
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
5244 Issued in FL
Practice address
3175 S Congress Ave
Suite 304
Palm Springs, FL 33461-2500
Phone
(561) 670-2957
NPI assigned
Jun 10, 2013
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5244 FL Primary

Addresses

Primary practice location

3175 S Congress Ave
Suite 304
Palm Springs, FL 33461-2500

Mailing address

3175 S Congress Ave
Suite 304
Palm Springs, FL 33461-2500
Phone (561) 670-2957

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

LicenseStateTypeSpecialty
5244FLMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1861830085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 S CONGRESS AVE",
            "address_2": "SUITE 304",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612500",
            "telephone_number": "561-670-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 S CONGRESS AVE",
            "address_2": "SUITE 304",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612500",
            "telephone_number": "561-670-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "5244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.