MEDICARE: JENNIFER LYNN 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
1	1041C0700X	Clinical Social Worker	0904010925	VA

General Provider Information

NPI Number	:	1588973614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN BROWN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 28746
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-8746
Country	:	US
Telephone Number	:	804-404-3177
Fax Number	:

Provider Business Practice Location Address
First Line	:	12093 GAYTON RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-3401
Country	:	US
Telephone Number	:	804-404-3177
Fax Number	:

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

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	06/23/2026

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