| Letitia O. Brown Lcsw, P.c. | |
|
631 Montauk Hwy Ste 5 West Islip NY 11795-4400 | |
| (516) 761-0523 | |
| (631) 588-1343 |
| Full Name | Letitia O. Brown Lcsw, P.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 631 Montauk Hwy Ste 5, West Islip, New York |
| Authorized Official Name and Position | Letitia Olivia Brown (PRESIDENT) |
| Authorized Official Contact | 5167610523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Letitia O. Brown Lcsw, P.c. 631 Montauk Hwy Ste 5 West Islip NY 11795-4400 Ph: (516) 761-0523 | Letitia O. Brown Lcsw, P.c. 631 Montauk Hwy Ste 5 West Islip NY 11795-4400 Ph: (516) 761-0523 |
| NPI Number | 1104321116 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 03/30/2018 |
| Medicare PECOS PAC ID | 5496018640 |
|---|---|
| Medicare Enrollment ID | O20180423000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104321116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 079892 (New York) | Primary |
| Provider Name | Letitia O Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356422802 PECOS PAC ID: 5597914853 Enrollment ID: I20121001000325 |
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