Provider Demographics
NPI:1962998245
Name:MUGO, BROOKE SCHOBER (LCSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:SCHOBER
Last Name:MUGO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ALEWIFE BROOK PKWY # 1258
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1102
Mailing Address - Country:US
Mailing Address - Phone:617-468-4916
Mailing Address - Fax:
Practice Address - Street 1:160 ALEWIFE BROOK PKWY # 1258
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1102
Practice Address - Country:US
Practice Address - Phone:617-468-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1233311041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical