Provider Demographics
NPI:1588970370
Name:BROWN, REBECCA STEPHANIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:STEPHANIE
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 1:4549 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6210
Mailing Address - Country:US
Mailing Address - Phone:770-677-9300
Mailing Address - Fax:470-253-0322
Practice Address - Street 1:4549 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6210
Practice Address - Country:US
Practice Address - Phone:415-205-6715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33635101Y00000X
101YM0800X
CA712871041C0700X
GACSW0062221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health