MEDICARE: MRS. MAYA 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1891091666	OTHER		NPI

General Provider Information

NPI Number	:	1457860314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAYA BROWN MSW

Provider Business Mailing Address
First Line	:	1011 W BROADWAY AVE STE 110
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2531
Country	:	US
Telephone Number	:	612-886-4218
Fax Number	:	800-640-5242

Provider Business Practice Location Address
First Line	:	1011 W BROADWAY AVE STE 110
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2531
Country	:	US
Telephone Number	:	612-886-4218
Fax Number	:	800-640-5242

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

Provider Enumeration Date	:	09/23/2017
Last Update Date	:	05/11/2026

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