Brooke Andre' Easterly, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

6110 Shallowford Rd Ste B
Chattanooga, TN 37421

Phone

(423) 499-1031

NPI assigned

Jan 31, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke Andre Rudnik Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1902102569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD STE B",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211894",
            "telephone_number": "423-635-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD STE B",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-499-1031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 NW 11th Ter",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339936023",
            "country_code": "US",
            "telephone_number": "239-565-9831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASTERLY",
        "first_name": "BROOKE",
        "middle_name": "ANDRE'",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "RUDNIK",
            "middle_name": "ANDRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• East TN Anesthesia, PLLC
• East TN Facial Surgery, Inc
• East TN Neurology LLC
• Eastdale Family Dentistry
• Jonathan Easter
• Traci Valencia Eastman, APN
• Eastside Internal Medicine PC
• Eastside Pharmacy Inc
• Easy Go Transportation
• Cooper L Eaton, M.A. NCC

• Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.