Healthcare Provider Details

I. General information

NPI: 1962311639
Provider Name (Legal Business Name): ADAM DAVID BROWN LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N 12TH ST STE 704
BROOKLYN NY
11249-1002
US

IV. Provider business mailing address

7405 METROPOLITAN AVE STE 2F
MIDDLE VILLAGE NY
11379-2699
US

V. Phone/Fax

Practice location:
  • Phone: 888-711-5532
  • Fax:
Mailing address:
  • Phone: 888-711-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number129884
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: