WALTER BROOKS (NPI# 1669745675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669745675 |
Entity Type | Individual |
Full Name | WALTER BROOKS |
Credential | PHD, LPC |
Practice Address |
159 Forsyth St Sw Atlanta GA 30303-3634 |
Mailing Address |
Po Box 55469 Atlanta GA 30308-5469 |
Practice Telephone | 4045234599 |
Practice Fax Number | 4045860645 |
Mailing Telephone | 4045234599 |
Mailing Fax Number | 4045860645 |
Enumeration Date | 2012-02-22 |
Last Update Date | 2020-01-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103TC1900X |
Psychologist Specialization: Counseling |
1091587 | GA | Behavioral Health & Social Service Providers |
Y | 103TH0100X |
Psychologist Specialization: Health Service |
LPC003956 | GA | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | DRIVERS LICENSE | 033128490 | 01 |
GA | PHD HUMAN SERVICES PROFESSIONAL COUNSELING SPECIALIZATION | 1091587 | 01 |
GA | LICENSE PROFESSIONAL COUNSELING | LPC003956 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992229181 | Walter Wayne Brooks | Physical Therapy Assistant | 9625 Lea Shore St, Ft Worth, TX 76179-3226 | 2017-07-28 |
1497360010 | Walter Brooks IIi | Physical Therapist | 3440 Highway 81, Loganville, GA 30052-9112 | 2020-09-10 |
1043273279 | Walter S Brooks | Dermatology | 730 Weiland Rd, Rochester, NY 14626-3919 | 2006-04-10 |
1326039330 | Walter Scott Brooks | Internal Medicine | 35 Collier Rd Nw, Suite 535, Atlanta, GA 30309-1613 | 2005-10-31 |
Street Address |
159 FORSYTH ST SW |
City | ATLANTA |
State | GA |
Zip Code | 30303-3634 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437576253 | Original Michael | Counselor | 159 Forsyth St Sw, Atlanta, GA 30303-3634 | 2014-03-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
1952917155 | Alesha Deshay Elbert | Behavior Technician | 206 Peachstreet Ne Suite 2200, Atlanta, GA 30303 | 2020-09-22 |
1033759386 | Mark Bush | Case Manager/Care Coordinator | 50 Hurt Plaza Se Suite 1108, Atlanta, GA 30303 | 2020-01-14 |
1053965855 | Patrice Munsel Henry | Nurse Practitioner | 80 Jessie Hill Drive Se, Atlanta, GA 30303 | 2019-07-30 |
1356826564 | United States Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 260 Peachtree Street Nw, Suite 2200, Office 2228, Atlanta, GA 30303 | 2018-10-03 |
1336645290 | Joseph Bahng | Student in an Organized Health Care Education/Training Program | 69 Jesse Hill Jr Drive Se, Glenn Building, 4th Floor - 412b, Atlanta, GA 30303 | 2018-03-31 |
1841704707 | Amber Peach LLC | Family Medicine | 260 Peachtree St Nw Suite 2200, Atlanta, GA 30303 | 2017-11-29 |
1447778089 | Jasmine Williams | Behavioral Analyst | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-09-05 |
1982138236 | Mahek Dossani | Behavior Technician | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-04-13 |
1255872420 | Alexis Annick Auger | Behavior Technician | 260 Peachtree St. Nw, Suite 2200, Atlanta, GA 30303 | 2017-03-20 |
Find all providers in zip 30303 |
Taxonomy Code | 103TH0100X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Health Service |
A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811160740 | Jacqueline Johnson | Psychologist | 2107 Gardenwood Ct, Atlanta, GA 30349 | 2008-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629692595 | Karol Short | Psychologist | 101 Sable Chase Blvd, Mcdonough, GA 30253-3456 | 2020-06-05 |
1740834092 | Shenitta Guyton | Psychologist | 619 Grecken Grn, Peachtree City, GA 30269 | 2019-07-25 |
1265092654 | Calvary Healthcare, Inc | Psychologist | 256 Van Dell Dr, Rock Spring, GA 30739-2640 | 2019-06-18 |
1215597182 | Mind Family & Social Services, Inc | Psychologist | 153 Lee Byrd Rd # 3, Loganville, GA 30052-2310 | 2019-06-13 |
1790206555 | Lauren Elizabeth Bigham | Psychologist | 997 Saint Sebastian Way # Eg202110, Augusta, GA 30912-2613 | 2017-07-03 |
1154729333 | Katie C Daniels | Psychologist | 1119 Old River Rd, Darien, GA 31305 | 2014-12-19 |
1093070773 | Family First Medical Center LLC | Psychologist | 1203 Cleveland Ave Ste 1, East Point, GA 30344-3417 | 2012-07-09 |
1841310497 | Walter Gregory Cox | Psychologist | 2923 Player St, Brunswick, GA 31520-4950 | 2007-03-29 |
1699882068 | Thomas H. White | Psychologist | 451 Ee Butler Pkwy, Gainesville, GA 30501-4524 | 2006-08-23 |
1124353339 | Pro- Holism Professional Corporation | Psychologist | 2480 Windy Hill Rd Se, Suite 206, Marietta, GA 30067-8644 | 2009-10-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.