Provider Demographics
NPI:1952478117
Name:BROWN, RITA DEANS (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:DEANS
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 MISTY MORN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5521
Mailing Address - Country:US
Mailing Address - Phone:704-536-5219
Mailing Address - Fax:704-568-8240
Practice Address - Street 1:7108 MISTY MORN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-5521
Practice Address - Country:US
Practice Address - Phone:704-536-5219
Practice Address - Fax:704-568-8240
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0026651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002199Medicaid