Provider Demographics
NPI:1467582700
Name:BROWN, MARTHA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ELIZABETH
Other - Last Name:GESTRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6150 OAKMONT TRL APT 225
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3091
Mailing Address - Country:US
Mailing Address - Phone:817-247-9494
Mailing Address - Fax:
Practice Address - Street 1:1730 WOODSTEAD CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-1411
Practice Address - Country:US
Practice Address - Phone:281-292-0422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21706104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker