Provider Demographics
NPI:1306044367
Name:BROWN, KIMBERLY (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
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 1:14090 SOUTHWEST FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3679
Mailing Address - Country:US
Mailing Address - Phone:281-513-0903
Mailing Address - Fax:832-945-2383
Practice Address - Street 1:14090 SOUTHWEST FWY
Practice Address - Street 2:STE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3679
Practice Address - Country:US
Practice Address - Phone:281-513-0903
Practice Address - Fax:832-945-2383
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX389391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213505503Medicaid
TXTXB147811Medicare PIN