Provider Demographics
NPI:1063856490
Name:BROWN, ERICA (LMSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BROWN
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 1:1000 FARRAH LN
Mailing Address - Street 2:#1124
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4589
Mailing Address - Country:US
Mailing Address - Phone:859-396-6750
Mailing Address - Fax:
Practice Address - Street 1:1000 FARRAH LN
Practice Address - Street 2:#1124
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4589
Practice Address - Country:US
Practice Address - Phone:859-396-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57689104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker