Provider Demographics
NPI:1992100416
Name:ANGELA RENE BROWN, LCSW, LLC
Entity type:Organization
Organization Name:ANGELA RENE BROWN, LCSW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-600-1999
Mailing Address - Street 1:508 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1674
Mailing Address - Country:US
Mailing Address - Phone:815-600-1999
Mailing Address - Fax:847-426-4219
Practice Address - Street 1:600 SPRING HILL RING RD STE 118
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-7301
Practice Address - Country:US
Practice Address - Phone:815-600-1999
Practice Address - Fax:847-426-4219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty