Provider Demographics
NPI:1134525959
Name:BROWN, STEPHANIE M
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15230 REGINA DR
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-4225
Mailing Address - Country:US
Mailing Address - Phone:240-844-2441
Mailing Address - Fax:
Practice Address - Street 1:15230 REGINA DR
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-4225
Practice Address - Country:US
Practice Address - Phone:240-844-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500811571041C0700X
MD183871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical