MEDICARE: ANGEL BROWN LISW-CP

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	18628	SC

General Provider Information

NPI Number	:	1396418398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL BROWN LISW-CP

Provider Business Mailing Address
First Line	:	2982 CANE SLASH RD
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	163 RUTLEDGE AVE STE 200
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8903
Country	:	US
Telephone Number	:	843-792-0819
Fax Number	:

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

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	03/05/2026

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Directions to “ ANGEL BROWN LISW-CP” Practice Location

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