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General NPI Number Information
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NPI Number | 1922343003
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Entity Type | Individual
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Provider Name | STEPHANIE JANE BROWN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 551 PEACEDALE ST
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City | BRISTOL
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State | CT
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Zip | 06010-8939
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Country | US
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Telephone | 860-212-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 36 ROSEMONT AVE
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City | BRISTOL
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State | CT
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Zip | 06010-7216
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Country | US
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Telephone | 860-212-8442
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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 | 001423
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9233
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License Number State | CT
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