Provider Demographics
NPI:1164042891
Name:BROWN, CASSANDRA R (LMSW, LICSW, PIP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW, LICSW, PIP
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 68
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35021-0068
Mailing Address - Country:US
Mailing Address - Phone:205-249-8101
Mailing Address - Fax:
Practice Address - Street 1:601 19TH ST N STE 25
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-2229
Practice Address - Country:US
Practice Address - Phone:205-249-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1589-4378C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health