MEDICARE: MELISSA LOUISE BROWN LCSW-C

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	10981	MD
2	1041C0700X	Clinical Social Worker	LC303357	DC

General Provider Information

NPI Number	:	1578841995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LOUISE BROWN LCSW-C

Provider Business Mailing Address
First Line	:	700 LEEWARD CT
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5261
Country	:	US
Telephone Number	:	301-806-6606
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 LEEWARD CT
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5261
Country	:	US
Telephone Number	:	301-806-6606
Fax Number	:

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

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	08/02/2011

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