Healthcare Provider Details

I. General information

NPI: 1942747035
Provider Name (Legal Business Name): MELINDA BETH BROWN MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N MACOMB ST STE 200
MONROE MI
48162-2904
US

IV. Provider business mailing address

1 SEAGATE
TOLEDO OH
43604-1558
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-1760
  • Fax: 734-240-1763
Mailing address:
  • Phone:
  • Fax: 419-824-7359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6802087966
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS 1500598
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: