Provider Demographics
NPI:1497242465
Name:BROWN, MINELL MAE (LMSW)
Entity Type:Individual
Prefix:
First Name:MINELL
Middle Name:MAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15511 TUCKERTON RD APT 817
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5317
Mailing Address - Country:US
Mailing Address - Phone:832-799-2663
Mailing Address - Fax:866-307-9980
Practice Address - Street 1:15511 TUCKERTON RD APT 817
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5317
Practice Address - Country:US
Practice Address - Phone:832-799-2663
Practice Address - Fax:866-307-9980
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65070171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty