Provider Demographics
NPI:1053807552
Name:BROWN, DANA L (LMSW, SSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW, SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28000 WOODWARD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0961
Mailing Address - Country:US
Mailing Address - Phone:248-395-3777
Mailing Address - Fax:248-996-6166
Practice Address - Street 1:28000 WOODWARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0961
Practice Address - Country:US
Practice Address - Phone:248-395-3777
Practice Address - Fax:248-996-6166
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010892731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical