Healthcare Provider Details

I. General information

NPI: 1568597151
Provider Name (Legal Business Name): RICHARD HENRY BROWN JR. LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 E ASCENSION COMPLEX AVENUE
GONZALES LA
70737
US

IV. Provider business mailing address

4615 GOVERNMENT ST
BATON ROUGE LA
70806-5922
US

V. Phone/Fax

Practice location:
  • Phone: 225-621-5770
  • Fax: 225-644-5168
Mailing address:
  • Phone: 225-922-0631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5731
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: