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NPI Code Detail

MEDICARE: MS. SUE ANN BINGHAM BROWN MSW, LCSW, PIP

MEDICARE: MS. SUE ANN BINGHAM BROWN MSW, LCSW, PIP
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
11041C0700XClinical Social Worker0598-1586CAL
21041C0700XClinical Social WorkerC009929NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251512925BROOTHERALBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1013054105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUE ANN BINGHAM BROWN MSW, LCSW, PIP
Provider Business Mailing Address
First Line : PO BOX 4962
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-4962
Country : US
Telephone Number : 704-360-3637
Fax Number :
Provider Business Practice Location Address
First Line : 276 OLD MOCKSVILLE RD STE 100
Second Line :
City : STATESVILLE
State : NC
Zip : 28625-1951
Country : US
Telephone Number : 704-317-2931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 02/02/2024

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