Provider Demographics
NPI:1679723670
Name:BROWN, MERRILL A (LCSW-C)
Entity type:Individual
Prefix:
First Name:MERRILL
Middle Name:A
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 1:174 GREENMEADOW WAY APT J
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9320 ANNAPOLIS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3100
Practice Address - Country:US
Practice Address - Phone:301-577-8152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119091041C0700X
MI68010800191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical