Provider Demographics
NPI:1326599978
Name:BROWN, LISA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:8737 VETERANS HWY.
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108
Mailing Address - Country:US
Mailing Address - Phone:410-218-3140
Mailing Address - Fax:
Practice Address - Street 1:8737 VETERANS HWY
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2046
Practice Address - Country:US
Practice Address - Phone:410-218-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD186701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical