1952392920 NPI number — MS. CYNTHIA J BROWN MSW, LICSW

Table of content: MS. CYNTHIA J BROWN MSW, LICSW (NPI 1952392920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952392920 NPI number — MS. CYNTHIA J BROWN MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
CYNTHIA
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW
Provider Gender Code:
F

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:
1952392920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 CHURCH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRIMAC
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01860-1528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-835-8497
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 SUMMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAVERHILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01830-5853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-835-8497
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2005

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:  1024830 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1855344 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2274371 . This is a "FIRST HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 62-83272 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P08356 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 11352634 . This is a "CAQH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 485625 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 232004 . This is a "COMPSYCH CORPORATION" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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