Provider Demographics
NPI:1811652399
Name:BROWN, J PATRICK (LCSW)
Entity type:Individual
Prefix:
First Name:J
Middle Name:PATRICK
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PLYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2868
Mailing Address - Country:US
Mailing Address - Phone:610-812-1266
Mailing Address - Fax:
Practice Address - Street 1:50 PLYMOUTH DR
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2868
Practice Address - Country:US
Practice Address - Phone:610-812-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0213551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW021355OtherCLINICAL SOCIAL WORK LICENSE