Healthcare Provider Details

I. General information

NPI: 1003519927
Provider Name (Legal Business Name): SHANEEA LAREE BROWN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 OREGON PIKE
LANCASTER PA
17601-6401
US

IV. Provider business mailing address

1803 OREGON PIKE
LANCASTER PA
17601-6401
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-9969
  • Fax: 717-560-9553
Mailing address:
  • Phone: 717-560-9969
  • Fax: 717-560-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW141190
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: