MEDICARE: MRS. MARILYN CORONA 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	12208	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12208	OTHER	LA	LCSW

General Provider Information

NPI Number	:	1841768496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARILYN CORONA BROWN LCSW

Provider Business Mailing Address
First Line	:	131 MICAH EDWARD DR
Second Line	:
City	:	MAURICE
State	:	LA
Zip	:	70555-3394
Country	:	US
Telephone Number	:	337-636-6021
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 TRAVIS ST STE 10B
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2461
Country	:	US
Telephone Number	:	337-486-3542
Fax Number	:

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

Provider Enumeration Date	:	11/12/2018
Last Update Date	:	03/02/2026

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