Provider Demographics
NPI:1053143602
Name:ADKINS, BROOKE ALLYSON (LGSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALLYSON
Last Name:ADKINS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-5728
Mailing Address - Country:US
Mailing Address - Phone:304-688-2871
Mailing Address - Fax:
Practice Address - Street 1:101 DINGESS ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3603
Practice Address - Country:US
Practice Address - Phone:304-688-9269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker