Provider Demographics
NPI:1649800889
Name:BROWN, COURTNEY JOHNSON (LCSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JOHNSON
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 INTERSTATE DR STE D
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3409
Mailing Address - Country:US
Mailing Address - Phone:931-444-1000
Mailing Address - Fax:
Practice Address - Street 1:482 INTERSTATE DR STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3409
Practice Address - Country:US
Practice Address - Phone:931-444-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical