Provider Demographics
NPI:1063207413
Name:BROWN, ALEXIS SIMONE (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SIMONE
Last Name:BROWN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 154TH PL
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-4506
Mailing Address - Country:US
Mailing Address - Phone:708-497-8605
Mailing Address - Fax:
Practice Address - Street 1:530 154TH PL
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-4506
Practice Address - Country:US
Practice Address - Phone:708-497-8605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0265721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical