Provider Demographics
NPI:1528018959
Name:BROWN, BARRY RICHARD (LICSW)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:RICHARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 KICKEMUIT RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-1929
Mailing Address - Country:US
Mailing Address - Phone:401-245-8443
Mailing Address - Fax:
Practice Address - Street 1:849 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4342
Practice Address - Country:US
Practice Address - Phone:401-823-3777
Practice Address - Fax:401-823-5908
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW003191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical