Provider Demographics
NPI:1952731176
Name:BROWN, STEVEN RALLIS (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:RALLIS
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 1:201 W GUADALUPE RD STE 314
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3319
Mailing Address - Country:US
Mailing Address - Phone:480-632-1345
Mailing Address - Fax:480-632-1354
Practice Address - Street 1:201 W GUADALUPE RD STE 314
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3319
Practice Address - Country:US
Practice Address - Phone:480-632-1345
Practice Address - Fax:480-632-1354
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-138061041C0700X
UT345611-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical