| Lisa Brown, Lcsw L.l.c | |
|
13510 E Boundary Rd Suite 104 Midlothian VA 23112-4057 | |
| (804) 876-0239 | |
| Not Available |
| Full Name | Lisa Brown, Lcsw L.l.c |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 13510 E Boundary Rd, Midlothian, Virginia |
| Authorized Official Name and Position | Lisa M Brown (OWNER) |
| Authorized Official Contact | 8049260991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Brown, Lcsw L.l.c 13510 E Boundary Rd Suite 104 Midlothian VA 23112-4057 Ph: (804) 876-0239 | Lisa Brown, Lcsw L.l.c 13510 E Boundary Rd Suite 104 Midlothian VA 23112-4057 Ph: (804) 876-0239 |
| NPI Number | 1073917860 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Medicare PECOS PAC ID | 1456674209 |
|---|---|
| Medicare Enrollment ID | O20141230002577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073917860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904005572 (Virginia) | Primary |
| Provider Name | Lisa Marie Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780771667 PECOS PAC ID: 9931108743 Enrollment ID: I20120113000375 |
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