Healthcare Provider Details

I. General information

NPI: 1447806211
Provider Name (Legal Business Name): DANIELLE LATRICE BROWN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 08/14/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPC 41 OPC 41 BOX 15
APO AE
09461
US

IV. Provider business mailing address

OPC 41 BOX 15
APO AE
09461
US

V. Phone/Fax

Practice location:
  • Phone: 314-226-8010
  • Fax:
Mailing address:
  • Phone: 315-225-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC014122
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: