MEDICARE: MRS. CATHY LEVINE 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	0904004046	VA

General Provider Information

NPI Number	:	1235415407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHY LEVINE BROWN LCSW

Provider Business Mailing Address
First Line	:	3433 BRAMBLETON AVE
Second Line	:	SUITE 201A
City	:	ROANOKE
State	:	VA
Zip	:	24018-6515
Country	:	US
Telephone Number	:	540-266-7550
Fax Number	:	540-266-7230

Provider Business Practice Location Address
First Line	:	3433 BRAMBLETON AVE
Second Line	:	SUITE 201A
City	:	ROANOKE
State	:	VA
Zip	:	24018-6515
Country	:	US
Telephone Number	:	540-266-7550
Fax Number	:	540-266-7230

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

Provider Enumeration Date	:	11/01/2011
Last Update Date	:	11/01/2011

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