Healthcare Provider Details

I. General information

NPI: 1780518803
Provider Name (Legal Business Name): JAMELLIA BROWN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EMANCIPATION DR
HAMPTON VA
23667-0001
US

IV. Provider business mailing address

3940 WATERWAY PL APT 812
VIRGINIA BEACH VA
23452-2040
US

V. Phone/Fax

Practice location:
  • Phone: 757-936-1297
  • Fax:
Mailing address:
  • Phone: 757-949-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04467
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: