Provider Demographics
NPI:1053503409
Name:BROOKS, KARMA L (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KARMA
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 NE GOING STREET
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211
Mailing Address - Country:US
Mailing Address - Phone:503-351-7969
Mailing Address - Fax:503-914-1818
Practice Address - Street 1:2819 NE GOING STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211
Practice Address - Country:US
Practice Address - Phone:503-351-7969
Practice Address - Fax:503-914-1818
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR35871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical