Provider Demographics
NPI:1891228375
Name:BROWN, DOUGLAS ALAN (LCSW)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ALAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BROADWAY
Mailing Address - Street 2:SUITE 2070
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5602
Mailing Address - Country:US
Mailing Address - Phone:212-227-4343
Mailing Address - Fax:
Practice Address - Street 1:225 E BROADWAY STE 2070
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5602
Practice Address - Country:US
Practice Address - Phone:212-227-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098740-11041C0700X
NY0913161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical