Provider Demographics
NPI:1538134929
Name:RICHARDSON-BROWN, CATHY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:
Last Name:RICHARDSON-BROWN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 597 MERRIMACK STREET
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-746-7778
Mailing Address - Fax:978-970-0359
Practice Address - Street 1:585 MERRIMACK STREET
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-746-7778
Practice Address - Fax:978-970-0359
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1077911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAUX9093OtherMEDICARE PTAN
MAP21276Medicare ID - Type Unspecified