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General NPI Number Information
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NPI Number | 1578072559
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Entity Type | Individual
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Provider Name | MICHAEL BENJAMIN BROWNBRIDGE MSW, LSW
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Gender | Male
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 09/22/2017
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Provider Practice Location Address
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Address Line | 6 CORNWALL CT STE B
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3347
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Country | US
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Telephone | 732-955-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 LORRAINE AVE
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City | UNION
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State | NJ
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Zip | 07083-7007
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Country | US
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Telephone | 609-271-9662
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Fax |
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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 | 44SL06290100
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License Number State | NJ
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