Provider Demographics
NPI:1740476837
Name:BROWN-SMALL, SCHERALDA
Entity type:Individual
Prefix:MRS
First Name:SCHERALDA
Middle Name:
Last Name:BROWN-SMALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SCHERALDA
Other - Middle Name:
Other - Last Name:BROWN-SMALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:769 CENTERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-2126
Mailing Address - Country:US
Mailing Address - Phone:631-491-4036
Mailing Address - Fax:
Practice Address - Street 1:769 CENTERWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-2126
Practice Address - Country:US
Practice Address - Phone:631-491-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0457581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical