Provider Demographics
NPI:1164283339
Name:BROWN, JULIAN XAVIER (LCSWA)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:XAVIER
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S BROAD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-3189
Mailing Address - Country:US
Mailing Address - Phone:704-660-6854
Mailing Address - Fax:
Practice Address - Street 1:207 S BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-3189
Practice Address - Country:US
Practice Address - Phone:704-660-6854
Practice Address - Fax:704-662-0866
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical