Healthcare Provider Details

I. General information

NPI: 1356021158
Provider Name (Legal Business Name): BROWNSTONE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 BUFFALO AVE APT 3A
BROOKLYN NY
11213-3984
US

IV. Provider business mailing address

261 BUFFALO AVE APT 3A
BROOKLYN NY
11213-3984
US

V. Phone/Fax

Practice location:
  • Phone: 908-922-1225
  • Fax:
Mailing address:
  • Phone: 908-922-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE GRANT MCKINNEY
Title or Position: OWNER
Credential: LCSW
Phone: 908-922-1225