Provider Demographics
NPI:1588782072
Name:BROWN, AMY WHITLEY (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:WHITLEY
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:W
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:BUIES CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27506
Mailing Address - Country:US
Mailing Address - Phone:910-893-5727
Mailing Address - Fax:910-893-6404
Practice Address - Street 1:5841 US HWY 421 SOUTH
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546
Practice Address - Country:US
Practice Address - Phone:910-893-5727
Practice Address - Fax:910-893-6404
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106891Medicaid
NC2860051Medicare PIN