MEDICARE: KELLY A BROWN LMSW

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	6801116861	MI
2	104100000X	Social Worker	6801116861	MI

General Provider Information

NPI Number	:	1265081061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY A BROWN LMSW

Provider Business Mailing Address
First Line	:	6189 COVENTRY DR
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-9535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4896 CHILSON RD
Second Line	:
City	:	HOWELL
State	:	MI
Zip	:	48843-9453
Country	:	US
Telephone Number	:	989-520-4744
Fax Number	:

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

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	05/13/2026

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Directions to “ KELLY A BROWN LMSW” Practice Location

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