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General NPI Number Information
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NPI Number | 1790177640
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Entity Type | Individual
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Provider Name | MERISSA BROWN LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 03/02/2015
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 4709 HARFORD ROAD SUITE A, 2ND FL #11
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City | BALTIMORE
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State | MD
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Zip | 21214-3261
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Country | US
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Telephone | 410-648-9707
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Fax | 410-878-7344
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Provider Business Mailing Address
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Address Line | 4709 HARFORD ROAD SUITE A, 2ND FL #11
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City | BALTIMORE
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State | MD
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Zip | 21214-3261
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Country | US
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Telephone | 410-648-9707
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 19550
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License Number State | MD
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