Provider Demographics
NPI:1821704214
Name:BROWN, ANTHONY (LMSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 VETERANS MEMORIAL HWY. SE
Mailing Address - Street 2:SUITE 660 #200
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-7711
Mailing Address - Country:US
Mailing Address - Phone:678-515-6681
Mailing Address - Fax:800-963-8202
Practice Address - Street 1:1025 VETERANS MEMORIAL HWY. SE
Practice Address - Street 2:SUITE 660 #200
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-3012
Practice Address - Country:US
Practice Address - Phone:678-515-6681
Practice Address - Fax:800-963-8202
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010663104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker