Basic Information
| Provider Information | |||||||||
| NPI: | 1528286531 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | DUNNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 153 VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105361714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145236687 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6 GRAMATAN AVE | ||||||||
| Address2: | C/O WJCS, SUITE 401 | ||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105503208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146688938 | ||||||||
| FaxNumber: | 9146682545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 02/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 080557 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.