MEDICARE: SUSAN BROWNE MSW

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	6801000712	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	80-0896360	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1235139502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BROWNE MSW

Provider Business Mailing Address
First Line	:	131 KERCHEVAL AVE
Second Line	:	SUITE 305
City	:	GROSSE POINTE FARMS
State	:	MI
Zip	:	48236-3629
Country	:	US
Telephone Number	:	313-882-1430
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 KERCHEVAL AVE
Second Line	:	SUITE 305
City	:	GROSSE POINTE FARMS
State	:	MI
Zip	:	48236-3629
Country	:	US
Telephone Number	:	313-882-1430
Fax Number	:

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	02/08/2012

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Directions to “ SUSAN BROWNE MSW” Practice Location

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