Healthcare Provider Details

I. General information

NPI: 1245332733
Provider Name (Legal Business Name): ROBERT CHARLES BROWN LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 BALTIMORE BLVD SUITE C
WESTMINSTER MD
21157-7146
US

IV. Provider business mailing address

511 DELLVIEW DR
FINKSBURG MD
21048-1018
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-6176
  • Fax: 410-857-4176
Mailing address:
  • Phone: 410-840-4431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05000
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: