Provider Demographics
NPI:1114612520
Name:WEBSTER, BROOKE ANN (LICSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:WEBSTER
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 1:8031 W CENTER RD STE 307
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3134
Mailing Address - Country:US
Mailing Address - Phone:402-915-3782
Mailing Address - Fax:
Practice Address - Street 1:8031 W CENTER RD STE 307
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3134
Practice Address - Country:US
Practice Address - Phone:402-915-3782
Practice Address - Fax:531-800-5210
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1272831041C0700X
NE38611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical