Provider Demographics
NPI:1477149359
Name:BROWN, JO ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JO
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JO
Other - Middle Name:ANN
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:135 PINELAWN RD STE 204N
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3133
Mailing Address - Country:US
Mailing Address - Phone:844-888-0355
Mailing Address - Fax:844-222-4005
Practice Address - Street 1:1908 LYDIAN DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-3258
Practice Address - Country:US
Practice Address - Phone:262-833-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical