Provider Demographics
NPI:1366681306
Name:BROWN, DEBORAH (LCSW, LADC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW, LADC
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 1360
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-1360
Mailing Address - Country:US
Mailing Address - Phone:207-893-0386
Mailing Address - Fax:207-893-2086
Practice Address - Street 1:222 SAINT JOHN ST
Practice Address - Street 2:STE 144
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3000
Practice Address - Country:US
Practice Address - Phone:207-240-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-15
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3982101YA0400X
MELC97191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)