Provider Demographics
NPI:1619451515
Name:BROWN, VIOLA 'VI-ANNE' ANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:VIOLA 'VI-ANNE'
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:VIOLA ('VI-ANNE')
Other - Middle Name:ANNE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:118 WHITING ST
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1483
Mailing Address - Country:US
Mailing Address - Phone:617-750-6653
Mailing Address - Fax:
Practice Address - Street 1:48 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1595
Practice Address - Country:US
Practice Address - Phone:508-490-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANONEOtherNONE