Provider Demographics
NPI:1902074099
Name:BROWN, DANIELLA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4914
Mailing Address - Country:US
Mailing Address - Phone:410-366-1980
Mailing Address - Fax:410-366-8530
Practice Address - Street 1:45 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3858
Practice Address - Country:US
Practice Address - Phone:410-571-8341
Practice Address - Fax:410-571-8368
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
92708701OtherCAREFIRST BCBS
MDT541-0092OtherCAREFIRST BCBS
MD016440200Medicaid
MD600495-202OtherMAGELLAN HEALTHCARE
MD218557OtherCOMPSYCH
MD016440200Medicaid