Provider Demographics
NPI:1417449877
Name:BROWN, ROBERT C (LICSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7442
Mailing Address - Country:US
Mailing Address - Phone:978-469-8800
Mailing Address - Fax:978-469-8990
Practice Address - Street 1:3 FERRY ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:MA
Practice Address - Zip Code:01835-7442
Practice Address - Country:US
Practice Address - Phone:978-469-8800
Practice Address - Fax:978-469-8990
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical