MEDICARE: MS. BONNIE CARAWAY 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	SW10546	FL

General Provider Information

NPI Number	:	1427332352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIE CARAWAY BROWN LCSW

Provider Business Mailing Address
First Line	:	7100 PLANTATION RD
Second Line	:	SUITE 11
City	:	PENSACOLA
State	:	FL
Zip	:	32504-4206
Country	:	US
Telephone Number	:	850-232-6935
Fax Number	:	850-607-6935

Provider Business Practice Location Address
First Line	:	7100 PLANTATION RD
Second Line	:	SUITE 11
City	:	PENSACOLA
State	:	FL
Zip	:	32504-4206
Country	:	US
Telephone Number	:	850-232-6935
Fax Number	:	850-607-6935

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

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	02/20/2019

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