Provider Demographics
NPI:1891999116
Name:BROWN, STEVEN GLEN (BA, CAC-AD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:GLEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:BA, CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-0980
Mailing Address - Country:US
Mailing Address - Phone:410-535-5400
Mailing Address - Fax:
Practice Address - Street 1:975 SOLOMONS ISLAND ROAD, N
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-0980
Practice Address - Country:US
Practice Address - Phone:410-535-5400
Practice Address - Fax:410-535-0736
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDACO201101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)