Provider Demographics
NPI:1497717193
Name:BROWN, SUEANNE M (LSW)
Entity Type:Individual
Prefix:
First Name:SUEANNE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 S MAIN ST
Mailing Address - Street 2:WELLINGTON SQUARE, SUITE 307
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5370
Mailing Address - Country:US
Mailing Address - Phone:724-832-8009
Mailing Address - Fax:724-832-3619
Practice Address - Street 1:1225 S MAIN ST
Practice Address - Street 2:WELLINGTON SQUARE, SUITE 307
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5370
Practice Address - Country:US
Practice Address - Phone:724-832-8009
Practice Address - Fax:724-832-3619
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW000689E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health