Provider Demographics
NPI:1851766414
Name:MEADOWS-BROWN, EDHA SUE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EDHA
Middle Name:SUE
Last Name:MEADOWS-BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 BUCKINGHAM CIR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6505
Mailing Address - Country:US
Mailing Address - Phone:865-352-9059
Mailing Address - Fax:
Practice Address - Street 1:296 GAMBLE AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4943
Practice Address - Country:US
Practice Address - Phone:865-352-9059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000058591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical