Provider Demographics
NPI:1417591926
Name:BROWN, NANCY K (MSW, LISW-CP, CASAC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LISW-CP, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 FORMOSA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-1150
Mailing Address - Country:US
Mailing Address - Phone:803-738-3675
Mailing Address - Fax:
Practice Address - Street 1:810 DUTCH SQUARE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7318
Practice Address - Country:US
Practice Address - Phone:803-467-3673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC72511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical