Provider Demographics
NPI:1598955932
Name:BROWN, GEORGETTE L (LCSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:GEORGETTE
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 MADONNA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2908
Mailing Address - Country:US
Mailing Address - Phone:919-949-8139
Mailing Address - Fax:
Practice Address - Street 1:4606 PINEDALE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2324
Practice Address - Country:US
Practice Address - Phone:919-309-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51881041C0700X
MD191741041C0700X
NCC0045301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical