Provider Demographics
NPI:1477915429
Name:BROWN, LUPEDA TODNEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LUPEDA
Middle Name:TODNEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10448 S PULASKI RD
Mailing Address - Street 2:STE. 1
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4895
Mailing Address - Country:US
Mailing Address - Phone:708-499-2030
Mailing Address - Fax:708-634-3688
Practice Address - Street 1:10448 S PULASKI RD
Practice Address - Street 2:STE. 1
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4895
Practice Address - Country:US
Practice Address - Phone:708-499-2030
Practice Address - Fax:708-634-3688
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LCSW149-0158391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical