Provider Demographics
NPI:1467983726
Name:BROWN, GENEVA NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:GENEVA
Middle Name:NICOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GENEVA
Other - Middle Name:NICOLE
Other - Last Name:SCALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1319 N BRIGHTLEAF BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4876
Mailing Address - Country:US
Mailing Address - Phone:919-934-1314
Mailing Address - Fax:919-934-9108
Practice Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5480
Practice Address - Country:US
Practice Address - Phone:919-865-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0171331041C0700X
NCP0138001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty