Provider Demographics
NPI:1083463863
Name:BROWN, ELIZABETH TURBAK (LICSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TURBAK
Last Name:BROWN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 W LAKE ST UNIT 116
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5254
Mailing Address - Country:US
Mailing Address - Phone:651-274-1877
Mailing Address - Fax:
Practice Address - Street 1:11812 WAYZATA BLVD STE 200A
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55305-2008
Practice Address - Country:US
Practice Address - Phone:651-274-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN255941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical