Provider Demographics
NPI:1083783575
Name:BROWN, VONNIE R (LCSW)
Entity Type:Individual
Prefix:
First Name:VONNIE
Middle Name:R
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:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-761-2100
Mailing Address - Fax:406-791-9629
Practice Address - Street 1:915 1ST AVE S
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3705
Practice Address - Country:US
Practice Address - Phone:406-761-2100
Practice Address - Fax:406-791-9629
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP01503209OtherRAILROAD MEDICARE
MT0MT0702293OtherBLUE CROSS-SHIELD OF MONTANA
MT0000500820Medicaid
MT0MT0702293OtherBLUE CROSS-SHIELD OF MONTANA