Provider Demographics
NPI:1063290807
Name:BROWN, KARLY GAIL (LCSW-A; LCAS-A)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:GAIL
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW-A; LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 ARSENAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5478
Mailing Address - Country:US
Mailing Address - Phone:910-323-3368
Mailing Address - Fax:910-486-7000
Practice Address - Street 1:901 ARSENAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5478
Practice Address - Country:US
Practice Address - Phone:910-323-3368
Practice Address - Fax:910-486-7000
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0195251041C0700X
NC29164101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)