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NPI Code Detail

MEDICARE: MS. LORETTA BROWN LCSW

MEDICARE: MS. LORETTA BROWN 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 WorkerC012210NC

General Provider Information

NPI Number : 1467634329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LORETTA BROWN LCSW
Provider Business Mailing Address
First Line : 3604 DIAMOND SPRINGS DR
Second Line :
City : RALEIGH
State : NC
Zip : 27610-3782
Country : US
Telephone Number : 347-418-8132
Fax Number :
Provider Business Practice Location Address
First Line : 8601 SIX FORKS RD STE 400
Second Line :
City : RALEIGH
State : NC
Zip : 27615-2965
Country : US
Telephone Number : 919-520-8293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2007
Last Update Date : 08/09/2019

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