Healthcare Provider Details

I. General information

NPI: 1003864356
Provider Name (Legal Business Name): JANET M. BROWN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 SIMMONS ST
ERIE CO
80516-7201
US

IV. Provider business mailing address

361 SIMMONS ST
ERIE CO
80516-7201
US

V. Phone/Fax

Practice location:
  • Phone: 817-996-5664
  • Fax: 817-927-7578
Mailing address:
  • Phone: 817-996-5664
  • Fax: 817-927-7578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929170
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTPSW912
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number35546
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: