Provider Demographics
NPI:1952605545
Name:BROWNING, MANDY MELISSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:MELISSA
Last Name:BROWNING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1722 S GLENSTONE AVE STE J2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1530
Mailing Address - Country:US
Mailing Address - Phone:417-350-1254
Mailing Address - Fax:417-350-1247
Practice Address - Street 1:1722 S GLENSTONE AVE STE J2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1530
Practice Address - Country:US
Practice Address - Phone:417-350-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100318501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494345309Medicaid