1790861425 NPI number — SHEILA G. BROWN LCSW PLC

Table of content: (NPI 1790861425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790861425 NPI number — SHEILA G. BROWN LCSW PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHEILA G. BROWN LCSW PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790861425
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 28001
Provider Second Line Business Mailing Address:
STE. 103
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23228-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-262-9999
Provider Business Mailing Address Fax Number:
804-262-9993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2103 E PARHAM RD
Provider Second Line Business Practice Location Address:
STE. 103
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23228-2235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-262-9999
Provider Business Practice Location Address Fax Number:
804-262-9993
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
SHEILA
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
OWNER MANAGER
Authorized Official Telephone Number:
804-262-9999

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904004769 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 388383 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 255910 . This is a "VALUEOPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 084868 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0904004769 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 287139 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 287140 . This is a "ANTEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2105688 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 084868 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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