Healthcare Provider Details

I. General information

NPI: 1306769781
Provider Name (Legal Business Name): MICAIAH BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 W ANDREWS AVE STE R
HENDERSON NC
27536-2500
US

IV. Provider business mailing address

1209 HURT DR APT 1209
YOUNGSVILLE NC
27596-7694
US

V. Phone/Fax

Practice location:
  • Phone: 252-598-2462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: