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NPI Code Detail

MEDICARE: OCTAVIA MARIE BROWN LCSW-C

MEDICARE: OCTAVIA MARIE 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
11041C0700XClinical Social Worker20929MD

General Provider Information

NPI Number : 1912523150
Entity Type Code : Individual
Provider Name (Legal Business Name) : OCTAVIA MARIE BROWN LCSW-C
Provider Business Mailing Address
First Line : 16 SPINDRIFT WAY
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-1013
Country : US
Telephone Number : 443-995-5984
Fax Number :
Provider Business Practice Location Address
First Line : 1910 TOWNE CENTRE BLVD STE 250
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-3599
Country : US
Telephone Number : 443-995-5984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2020
Last Update Date : 06/23/2020

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Directions to “ OCTAVIA MARIE BROWN LCSW-C” Practice Location

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