Provider Demographics
NPI:1821091737
Name:BROWN, STEVEN PHILLIP (LISW-CP, DCSW, BCD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PHILLIP
Last Name:BROWN
Suffix:
Gender:M
Credentials:LISW-CP, DCSW, BCD
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:PHILLIP
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-CP, DCSW, BCD
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-0006
Mailing Address - Country:US
Mailing Address - Phone:864-582-4080
Mailing Address - Fax:864-574-4066
Practice Address - Street 1:151 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3241
Practice Address - Country:US
Practice Address - Phone:864-582-4080
Practice Address - Fax:864-574-4066
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC LIC#19041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ271239626OtherMEDICARE INDIVIDUAL PTAN
SC1821091737OtherNATIONAL PROVIDER IDENTIFICATION NUMBER 1821091737
SC1821091737OtherNATIONAL PROVIDER IDENTIFICATION NUMBER 1821091737
SCQ27123Medicare UPIN