Provider Demographics
NPI:1699318980
Name:BROWN, MONTE DEPREST (LCSW)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:DEPREST
Last Name:BROWN
Suffix:
Gender:M
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:PO BOX 471883
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33247-1883
Mailing Address - Country:US
Mailing Address - Phone:786-328-1042
Mailing Address - Fax:
Practice Address - Street 1:2400 NW 48TH ST APT 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-3797
Practice Address - Country:US
Practice Address - Phone:786-328-1042
Practice Address - Fax:855-275-5174
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-20
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 172V00000X
FLSW22886261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1023509817Medicaid