MEDICARE: MRS. ANGELICA NOEL CLARK BROWN 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	16584	MD
2	1041C0700X	Clinical Social Worker	LC50079678	DC

General Provider Information

NPI Number	:	1316075591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELICA NOEL CLARK BROWN MSW

Provider Business Mailing Address
First Line	:	401 SANDY SPRING RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-3513
Country	:	US
Telephone Number	:	240-461-1374
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 SANDY SPRING RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-3513
Country	:	US
Telephone Number	:	240-461-1374
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	05/13/2024

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