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Provider Information for 1699974253


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Mrs. JOAN M BROWN LCSW-R


Other Names:  
Former Name: 
Mrs. JOAN M BROWN LCSW-R

Sex: Female

NPI: 1699974253
Last Updated: 2024-08-22
Certification Date: 2024-08-22

Details

NameValue
NPI1699974253
Enumeration Date2007-07-13
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 90 HORNBROOK RD
ITHACA, NY 14850-9427
United States

Phone: | Fax:
 
Primary Practice Address 1019 E WATER ST
ELMIRA, NY 14901-3332
United States

Phone: 607-733-5696 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalNYR079037