Provider Demographics
NPI:1629265319
Name:BROWN, SHENA LEVERETT (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:SHENA
Middle Name:LEVERETT
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2153
Mailing Address - Country:US
Mailing Address - Phone:770-403-2907
Mailing Address - Fax:770-987-9757
Practice Address - Street 1:2964 PEACHTREE RD NW
Practice Address - Street 2:SUITE 510
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2153
Practice Address - Country:US
Practice Address - Phone:770-403-2907
Practice Address - Fax:770-987-9757
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA501944101YA0400X
GACSW0031191041C0700X
GA6955251041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool