Provider Demographics
NPI:1477709228
Name:BROWN, KEVIN SCOTT (LMSW)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:SCOTT
Last Name:BROWN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 73RD ST, STE 24
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1024
Mailing Address - Country:US
Mailing Address - Phone:515-200-7979
Mailing Address - Fax:515-276-9057
Practice Address - Street 1:974 73RD ST
Practice Address - Street 2:SUITE 24
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1024
Practice Address - Country:US
Practice Address - Phone:515-200-7979
Practice Address - Fax:515-267-9057
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00076101YA0400X
IA007136104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)