Provider Demographics
NPI:1003864356
Name:BROWN, JANET M (LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:BROWN
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 1:361 SIMMONS ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7201
Mailing Address - Country:US
Mailing Address - Phone:817-996-5664
Mailing Address - Fax:817-927-7578
Practice Address - Street 1:361 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7201
Practice Address - Country:US
Practice Address - Phone:817-996-5664
Practice Address - Fax:817-927-7578
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB130525OtherMEDICARE INDIVIDUAL PTAN
TX180498102Medicaid
TXTXB130525Medicare PIN