Provider Demographics
NPI:1386825867
Name:BROWN, PAUL CHARLES (LCSW, NCC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CHARLES
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCSW, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MAIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-0716
Mailing Address - Country:US
Mailing Address - Phone:608-606-6725
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-0716
Practice Address - Country:US
Practice Address - Phone:608-606-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2791-1231041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical