Provider Demographics
NPI:1700034402
Name:TWANDA L BROWN LCSW LLC
Entity Type:Organization
Organization Name:TWANDA L BROWN LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TWANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-688-1616
Mailing Address - Street 1:2816 MORRIS AVE
Mailing Address - Street 2:SUITE 28
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4849
Mailing Address - Country:US
Mailing Address - Phone:908-688-1616
Mailing Address - Fax:908-688-1162
Practice Address - Street 1:2816 MORRIS AVE
Practice Address - Street 2:SUITE 28
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4849
Practice Address - Country:US
Practice Address - Phone:908-688-1616
Practice Address - Fax:908-688-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053456001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ130189Medicare UPIN