MEDICARE: JANET BROWN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	266630-3501	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	266630-3501	OTHER	UT	STATE LICENSE

General Provider Information

NPI Number	:	1285771162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET BROWN LCSW

Provider Business Mailing Address
First Line	:	3654 MITCHELL DR
Second Line	:
City	:	SANTA CLARA
State	:	UT
Zip	:	84765-5397
Country	:	US
Telephone Number	:	435-519-7843
Fax Number	:	435-674-4660

Provider Business Practice Location Address
First Line	:	3654 MITCHELL DR
Second Line	:
City	:	SANTA CLARA
State	:	UT
Zip	:	84765-5397
Country	:	US
Telephone Number	:	435-619-7843
Fax Number	:	435-674-4660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	09/22/2014

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