Provider Demographics
NPI:1346472842
Name:BROWN, JEANNETTE HARRIS (MSW,P-LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:HARRIS
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW,P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 FAIRFAX RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1154
Mailing Address - Country:US
Mailing Address - Phone:252-514-3683
Mailing Address - Fax:
Practice Address - Street 1:2901 N HERRITAGE ST
Practice Address - Street 2:SUITE C
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1581
Practice Address - Country:US
Practice Address - Phone:252-514-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPOO4932104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker