Healthcare Provider Details

I. General information

NPI: 1629161039
Provider Name (Legal Business Name): LAURA J. BROWN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA J. THESSEN-BROWN L.C.S.W.

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 DEMOCRAT DR.
FRANKFORT KY
40601
US

IV. Provider business mailing address

251 DEMOCRAT DR.
FRANKFORT KY
40601
US

V. Phone/Fax

Practice location:
  • Phone: 866-755-4258
  • Fax:
Mailing address:
  • Phone: 866-755-4258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberKY-853
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: