Provider Demographics
NPI:1992994503
Name:BROOKES, BERNARD L (PHD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:L
Last Name:BROOKES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20407 WATERS POINT LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1066
Mailing Address - Country:US
Mailing Address - Phone:301-515-5310
Mailing Address - Fax:202-354-4760
Practice Address - Street 1:20407 WATERS POINT LN
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1066
Practice Address - Country:US
Practice Address - Phone:301-515-5310
Practice Address - Fax:202-354-4760
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04024103TC0700X
DCPSY1000259103TC0700X
MA3531103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical