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NPI Code Detail

MEDICARE: SANDRA A BROWN LSW, LMFT

MEDICARE: SANDRA A BROWN LSW, LMFT
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
1104100000XSocial Worker1660OK
2106H00000XMarriage & Family Therapist649OK

General Provider Information

NPI Number : 1902923881
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA A BROWN LSW, LMFT
Provider Business Mailing Address
First Line : 1209 SOVEREIGN ROW
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73108-1824
Country : US
Telephone Number : 405-942-5570
Fax Number : 405-942-5603
Provider Business Practice Location Address
First Line : 1209 SOVEREIGN ROW
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73108-1824
Country : US
Telephone Number : 405-942-5570
Fax Number : 405-942-5603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 09/11/2025

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