Provider Demographics
NPI:1336864081
Name:BROWN, DARSHELL WILLIAMS
Entity Type:Individual
Prefix:
First Name:DARSHELL
Middle Name:WILLIAMS
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 1:13751 LEMOLI AVE APT 213
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8915
Mailing Address - Country:US
Mailing Address - Phone:323-945-4556
Mailing Address - Fax:
Practice Address - Street 1:13751 LEMOLI AVE APT 213
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8915
Practice Address - Country:US
Practice Address - Phone:323-945-4556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW760081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical