Healthcare Provider Details

I. General information

NPI: 1316013253
Provider Name (Legal Business Name): SALLY A. ANN BROWN PHD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SALLY MEAD

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1176 E WARNER RD STE 102
GILBERT AZ
85296-3068
US

IV. Provider business mailing address

303 W SHAWNEE DR
CHANDLER AZ
85225-7185
US

V. Phone/Fax

Practice location:
  • Phone: 720-725-2115
  • Fax:
Mailing address:
  • Phone: 928-632-3332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW16760
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-06170
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16760
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW992910
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: