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NPI Code Detail

MEDICARE: SALLY A. ANN BROWN PHD, LCSW

MEDICARE: SALLY A. ANN BROWN PHD, 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
11041C0700XClinical Social WorkerI-06170NM
21041C0700XClinical Social WorkerLCSW16760AZ
31041C0700XClinical Social Worker16760AZ
41041C0700XClinical Social WorkerCSW992910CO

General Provider Information

NPI Number : 1316013253
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY A. ANN BROWN PHD, LCSW
Provider Business Mailing Address
First Line : 303 W SHAWNEE DR
Second Line :
City : CHANDLER
State : AZ
Zip : 85225-7185
Country : US
Telephone Number : 928-632-3332
Fax Number :
Provider Business Practice Location Address
First Line : 1910 S STAPLEY DR STE 209
Second Line :
City : MESA
State : AZ
Zip : 85204-6679
Country : US
Telephone Number : 928-632-3332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 04/08/2025

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