Provider Demographics
NPI:1790166528
Name:BROWN, JANICE S
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 SUNNYSIDE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2300
Mailing Address - Country:US
Mailing Address - Phone:301-474-0060
Mailing Address - Fax:301-474-0068
Practice Address - Street 1:5010 SUNNYSIDE AVE STE 201
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2300
Practice Address - Country:US
Practice Address - Phone:301-474-0060
Practice Address - Fax:301-474-0068
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6381101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor