Provider Demographics
NPI:1144388570
Name:BROWN, KATHRYN A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:STOCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:990 NW CIRCLE BLVD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-1410
Mailing Address - Country:US
Mailing Address - Phone:541-768-6412
Mailing Address - Fax:541-768-6643
Practice Address - Street 1:990 NW CIRCLE BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-1410
Practice Address - Country:US
Practice Address - Phone:541-768-6412
Practice Address - Fax:541-768-6643
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL20551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL2055OtherLICENSED CLINICAL SOC. WK