Provider Demographics
NPI:1730568205
Name:BROWN, MARY SUZANNE (LCSWA, LCASA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:SUZANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 WEAVER DAIRY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1791
Mailing Address - Country:US
Mailing Address - Phone:984-974-6326
Mailing Address - Fax:984-974-6447
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:984-974-6326
Practice Address - Fax:984-974-6447
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0080171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical