Provider Demographics
NPI:1053569079
Name:BROWN, ADAM (PHD, LCSW, LICSW)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHD, LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-0216
Mailing Address - Country:US
Mailing Address - Phone:508-510-0256
Mailing Address - Fax:
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:413-529-7266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059992001041C0700X
NY0875781041C0700X
MA1215901041C0700X
IL149.0143431041C0700X
IL1490143431041C0700X
WA605136961041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical