Healthcare Provider Details

I. General information

NPI: 1023164787
Provider Name (Legal Business Name): DEBRA A BROWN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 GROVE ST
WORCESTER MA
01605-3936
US

IV. Provider business mailing address

45 DRURY LN
WORCESTER MA
01609-1648
US

V. Phone/Fax

Practice location:
  • Phone: 774-303-4452
  • Fax: 508-365-6171
Mailing address:
  • Phone: 508-756-3064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110631
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: