Provider Demographics
NPI:1477037182
Name:BROWN, STEPHEN BRIAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BRIAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 W AGATITE AVE UNIT G
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6094
Mailing Address - Country:US
Mailing Address - Phone:773-255-1684
Mailing Address - Fax:
Practice Address - Street 1:920 W AGATITE AVE UNIT G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-6094
Practice Address - Country:US
Practice Address - Phone:773-255-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1500098831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150009883OtherSTATE OF ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION