Provider Demographics
NPI:1750543229
Name:STEWART-BROWN, LISA MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:STEWART-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 1:7710 HAZARD CENTER DR STE E519
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4550
Mailing Address - Country:US
Mailing Address - Phone:619-823-8026
Mailing Address - Fax:619-741-7262
Practice Address - Street 1:5100 MARLBOROUGH DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-2020
Practice Address - Country:US
Practice Address - Phone:619-823-8026
Practice Address - Fax:619-741-7262
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 180771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical