Provider Demographics
NPI:1154931632
Name:VARMA, BROOKE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:VARMA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:ANNESSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2971 LISMORE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2138
Mailing Address - Country:US
Mailing Address - Phone:571-292-7560
Mailing Address - Fax:
Practice Address - Street 1:2971 LISMORE LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2138
Practice Address - Country:US
Practice Address - Phone:571-292-7560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040096301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty