Provider Demographics
NPI:1770885444
Name:BROWN, JESSICA L (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:545 PROSPECT PL
Mailing Address - Street 2:9M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4266
Mailing Address - Country:US
Mailing Address - Phone:347-415-5955
Mailing Address - Fax:
Practice Address - Street 1:598 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3206
Practice Address - Country:US
Practice Address - Phone:212-966-9537
Practice Address - Fax:212-584-5450
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY081835104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker