1821091737 NPI number — MR. STEVEN PHILLIP BROWN LISW-CP, DCSW, BCD

Table of content: MR. STEVEN PHILLIP BROWN LISW-CP, DCSW, BCD (NPI 1821091737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821091737 NPI number — MR. STEVEN PHILLIP BROWN LISW-CP, DCSW, BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
STEVEN
Provider Middle Name:
PHILLIP
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LISW-CP, DCSW, BCD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
STEVEN
Provider Other Middle Name:
PHILLIP
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LISW-CP, DCSW, BCD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1821091737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROEBUCK
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29376-0006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-582-4080
Provider Business Mailing Address Fax Number:
864-574-4066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 S CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARTANBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29306-3241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-582-4080
Provider Business Practice Location Address Fax Number:
864-574-4066
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SC LIC#1904 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: Q271239626 . This is a "MEDICARE INDIVIDUAL PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1821091737 . This is a "NATIONAL PROVIDER IDENTIFICATION NUMBER 1821091737" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com