Provider Demographics
NPI:1285771162
Name:BROWN, JANET (LCSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3654 MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-5397
Mailing Address - Country:US
Mailing Address - Phone:435-519-7843
Mailing Address - Fax:435-674-4660
Practice Address - Street 1:3654 MITCHELL DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:UT
Practice Address - Zip Code:84765-5397
Practice Address - Country:US
Practice Address - Phone:435-619-7843
Practice Address - Fax:435-674-4660
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT266630-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT266630-3501OtherSTATE LICENSE
UT005529807Medicare ID - Type UnspecifiedST. GEORGE LOCATION