Doctor Name: | MS. IRENE R. BROOK |
NPI Number: | 1083799191 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | C004757 |
Business Practice Address: | 5003 Oquinn Blvd Se Ste B Southport, NC - 284617431 |
Business Phone Number: | 9104576335 |
Business Fax Number: | 9104576524 |
Mailing Address: | 5003 Oquinn Blvd Se Ste B, SOUTHPORT |
State: | NC |
Postal Code: | 284617431 |
Phone Number: | 9104576335 |
Fax Number: | 9104576524 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C004757 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |