Provider Demographics
NPI:1316075591
Name:CLARK BROWN, ANGELICA NOEL (MSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:NOEL
Last Name:CLARK BROWN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SANDY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3513
Mailing Address - Country:US
Mailing Address - Phone:240-461-1374
Mailing Address - Fax:
Practice Address - Street 1:401 SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3513
Practice Address - Country:US
Practice Address - Phone:240-461-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD165841041C0700X
DCLC500796781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical