Provider Demographics
NPI:1619054590
Name:BROWN, TERRI LYNN (LSCSW)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 W. CENTRAL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-6302
Mailing Address - Country:US
Mailing Address - Phone:316-945-5200
Mailing Address - Fax:316-945-5549
Practice Address - Street 1:6700 W CENTRAL AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-6302
Practice Address - Country:US
Practice Address - Phone:316-945-5200
Practice Address - Fax:316-945-5549
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical