MEDICARE: ADRIENNE BROWN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34007533A	IN

General Provider Information

NPI Number	:	1003361726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE BROWN LCSW

Provider Business Mailing Address
First Line	:	4810 MELBOURNE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46228-2088
Country	:	US
Telephone Number	:	317-332-9542
Fax Number	:

Provider Business Practice Location Address
First Line	:	8201 W WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1346
Country	:	US
Telephone Number	:	317-244-6848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	03/27/2017

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