Provider Demographics
NPI:1821386129
Name:BROWN, DEJUAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:DEJUAN
Middle Name:
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 1:1102 POPLAR LEVEL PLZ APT 7
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1326
Mailing Address - Country:US
Mailing Address - Phone:859-230-9566
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 379
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4838
Practice Address - Country:US
Practice Address - Phone:502-813-8280
Practice Address - Fax:502-813-8281
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2528781041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical