MEDICARE: MELISSA IRENE 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	149.013727	IL
2	1041C0700X	Clinical Social Worker	8105	TN

General Provider Information

NPI Number	:	1497006928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA IRENE BROWN LCSW

Provider Business Mailing Address
First Line	:	402 RIVENDELL RD
Second Line	:
City	:	WOODBURY
State	:	TN
Zip	:	37190-5975
Country	:	US
Telephone Number	:	815-715-1026
Fax Number	:

Provider Business Practice Location Address
First Line	:	4004 HILLSBORO RD STE A207
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2228
Country	:	US
Telephone Number	:	815-723-8286
Fax Number	:

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

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	01/06/2023

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