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General NPI Number Information
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NPI Number | 1619492956
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Entity Type | Individual
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Provider Name | EBONIE L BROWN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 3303 E BASELINE RD STE 109
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City | GILBERT
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State | AZ
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Zip | 85234
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Country | US
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Telephone | 480-900-8765
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 E INNOVATION PARK DR STE 100
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City | ORO VALLEY
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State | AZ
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Zip | 85755-1963
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Country | US
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Telephone | 480-719-0260
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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 | LCSW-22828
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License Number State | AZ
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