Provider Demographics
NPI:1902630965
Name:DAIRMAN, BROOKE ROBYN (LMSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ROBYN
Last Name:DAIRMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1212
Mailing Address - Country:US
Mailing Address - Phone:516-318-8142
Mailing Address - Fax:
Practice Address - Street 1:11 KRISTY DR
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-3001
Practice Address - Country:US
Practice Address - Phone:917-426-3538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10373104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker