Provider Demographics
NPI:1912126129
Name:BROWN WELLS, BEATRICE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:
Last Name:BROWN WELLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:LA
Mailing Address - Zip Code:71326-0474
Mailing Address - Country:US
Mailing Address - Phone:225-324-2994
Mailing Address - Fax:
Practice Address - Street 1:201 EE WALLACE BLVD N STE 2
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2821
Practice Address - Country:US
Practice Address - Phone:225-324-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA49211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical