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General NPI Number Information
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NPI Number | 1467983726
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Entity Type | Individual
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Provider Name | GENEVA NICOLE BROWN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 5000 FALLS OF NEUSE RD STE 300
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City | RALEIGH
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State | NC
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Zip | 27609-5480
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Country | US
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Telephone | 919-865-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 1319 N BRIGHTLEAF BLVD STE F
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City | SMITHFIELD
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State | NC
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Zip | 27577-4876
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Country | US
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Telephone | 919-934-1314
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Fax | 919-934-9108
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C017133
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License Number State | NC
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