Provider Demographics
NPI:1700953171
Name:BROWN, NICOLE N (LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:N
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 1:1416 SWEET HOME RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2784
Mailing Address - Country:US
Mailing Address - Phone:917-674-6742
Mailing Address - Fax:
Practice Address - Street 1:1416 SWEET HOME RD
Practice Address - Street 2:SUITE 3
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2784
Practice Address - Country:US
Practice Address - Phone:917-674-6742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0757151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical