Provider Demographics
NPI:1780981621
Name:BROWN, DEBRA K (LCSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:K
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-342-3002
Mailing Address - Fax:
Practice Address - Street 1:650 EAST AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1524
Practice Address - Country:US
Practice Address - Phone:814-455-5505
Practice Address - Fax:814-455-5515
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0164241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4207808OtherAETNA
PA1027509330002Medicaid
PA4207808OtherAETNA