Provider Demographics
NPI:1649786955
Name:BROOKS, ANN LORRAINE (LICSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LORRAINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NEW STATE HWY
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-5423
Mailing Address - Country:US
Mailing Address - Phone:781-666-2711
Mailing Address - Fax:781-666-2712
Practice Address - Street 1:100 NEW STATE HWY
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5423
Practice Address - Country:US
Practice Address - Phone:781-666-2711
Practice Address - Fax:781-666-2712
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT140971041C0700X
MA1203001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical