Provider Demographics
NPI:1710069802
Name:BROWN, CYNTHIA JOAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JOAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1121 LANE ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2019
Mailing Address - Country:US
Mailing Address - Phone:859-227-0465
Mailing Address - Fax:859-309-9898
Practice Address - Street 1:1078 WELLINGTON WAY
Practice Address - Street 2:#29-1 LEESTOWN DIVISION
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1200
Practice Address - Country:US
Practice Address - Phone:859-227-0465
Practice Address - Fax:859-309-9898
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical