Provider Demographics
NPI:1477073997
Name:BROWN, COLETTE (MA, MA ED, LMSW)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, MA ED, LMSW
Other - Prefix:MS
Other - First Name:COLETE
Other - Middle Name:INGRID
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MA ED, LCSW
Mailing Address - Street 1:225 BROADWAY STE 2010225
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3001
Mailing Address - Country:US
Mailing Address - Phone:212-227-4343
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY STE 2010
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3738
Practice Address - Country:US
Practice Address - Phone:212-227-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0956161041C0700X
NJ44SL06845100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SL06845100OtherNJ DCA SOCIAL WORK EXAMINERS