Provider Demographics
NPI:1285169680
Name:BROWN, FAYLA (MSW, CSW)
Entity type:Individual
Prefix:
First Name:FAYLA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:MRS
Other - First Name:FAYLA
Other - Middle Name:MARIE
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, CSW
Mailing Address - Street 1:4315 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9661
Mailing Address - Country:US
Mailing Address - Phone:318-305-7672
Mailing Address - Fax:
Practice Address - Street 1:4315 BLUEBONNET BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9661
Practice Address - Country:US
Practice Address - Phone:225-223-6968
Practice Address - Fax:225-442-1396
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18524104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker