Provider Demographics
NPI:1811125263
Name:CATLIN BROWN, BLAIR (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:
Last Name:CATLIN BROWN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:BLAIR
Other - Middle Name:
Other - Last Name:CATLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:23704 OCEAN GTWY
Mailing Address - Street 2:
Mailing Address - City:MARDELA SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:21837-2101
Mailing Address - Country:US
Mailing Address - Phone:410-422-2545
Mailing Address - Fax:410-677-0303
Practice Address - Street 1:23704 OCEAN GTWY
Practice Address - Street 2:
Practice Address - City:MARDELA SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:21837-2101
Practice Address - Country:US
Practice Address - Phone:410-422-2545
Practice Address - Fax:410-677-0303
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00011141041C0700X
MD151181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550002Medicaid
MD609550004Medicaid
MD609550001Medicaid