Healthcare Provider Details

I. General information

NPI: 1528793130
Provider Name (Legal Business Name): MISS PROMISE LASHAUN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25701 N LAKELAND BLVD STE 403
EUCLID OH
44132-2453
US

IV. Provider business mailing address

25701 N LAKELAND BLVD STE 403
EUCLID OH
44132-2453
US

V. Phone/Fax

Practice location:
  • Phone: 216-904-0951
  • Fax:
Mailing address:
  • Phone: 216-273-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: