Healthcare Provider Details

I. General information

NPI: 1093587016
Provider Name (Legal Business Name): AMANDA JOY BROWN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 07/22/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

6080 LAKEVIEW RD APT 3902
WARNER ROBINS GA
31088-9161
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-1210
  • Fax:
Mailing address:
  • Phone: 229-300-1712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW009437
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW008941
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: