Provider Demographics
NPI:1316013253
Name:BROWN, SALLY A. ANN (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:SALLY A.
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:MEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 W SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7185
Mailing Address - Country:US
Mailing Address - Phone:928-632-3332
Mailing Address - Fax:
Practice Address - Street 1:1910 S STAPLEY DR STE 209
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6679
Practice Address - Country:US
Practice Address - Phone:928-632-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-061701041C0700X
AZLCSW167601041C0700X
AZ167601041C0700X
COCSW9929101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical