Provider Demographics
NPI:1205119732
Name:BROWN, LINDA MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MICHELLE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3791 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46124
Mailing Address - Country:US
Mailing Address - Phone:812-348-0300
Mailing Address - Fax:
Practice Address - Street 1:3791 10TH STREET
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:IN
Practice Address - Zip Code:46124
Practice Address - Country:US
Practice Address - Phone:812-348-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007209A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical