Provider Demographics
NPI:1912382607
Name:BROWN, CLARE (LCSW)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name: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 1:2833 REMINGTON GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3752
Mailing Address - Country:US
Mailing Address - Phone:850-922-8375
Mailing Address - Fax:850-488-2071
Practice Address - Street 1:1531 SW COMMERCIAL GLN
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0454
Practice Address - Country:US
Practice Address - Phone:386-752-7813
Practice Address - Fax:386-752-7836
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL108671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical