Provider Demographics
NPI:1871306043
Name:MADL, BROOKE D (LCSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:D
Last Name:MADL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18832 GENOVA BAY CT
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-1778
Mailing Address - Country:US
Mailing Address - Phone:979-451-0089
Mailing Address - Fax:
Practice Address - Street 1:150 PINE FOREST DR STE 501
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-5304
Practice Address - Country:US
Practice Address - Phone:936-262-1677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical