Provider Demographics
NPI:1831232453
Name:BROWN, VICKY L (LCSW)
Entity type:Individual
Prefix:MS
First Name:VICKY
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6914 S KNOXVILLE PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-2621
Mailing Address - Country:US
Mailing Address - Phone:918-494-4835
Mailing Address - Fax:
Practice Address - Street 1:4720 S HARVARD AVE
Practice Address - Street 2:207
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3048
Practice Address - Country:US
Practice Address - Phone:918-748-9868
Practice Address - Fax:918-748-9835
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK02791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical