Provider Demographics
NPI:1255492005
Name:BROWN, PAMELA S (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 SIMSBURY RD APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5524
Mailing Address - Country:US
Mailing Address - Phone:980-875-9380
Mailing Address - Fax:
Practice Address - Street 1:4500 SIMSBURY RD APT B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5524
Practice Address - Country:US
Practice Address - Phone:980-875-9380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0024331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical