Provider Demographics
NPI:1982263562
Name:BROWN, HEATHER MAE (MSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BEAVERCREEK RD STE 419
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4302
Mailing Address - Country:US
Mailing Address - Phone:913-777-6433
Mailing Address - Fax:
Practice Address - Street 1:150 BEAVERCREEK RD STE 419
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4302
Practice Address - Country:US
Practice Address - Phone:913-777-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11289104100000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker