Individual provider Active NPI

David Stanley Brown, M.A.., LCSW

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1023121282
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2325 W White Oaks Dr
Springfield, IL 62704-7419
Phone
(217) 793-3949
Fax
(217) 793-3995
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

2325 W White Oaks Dr
Springfield, IL 62704-7419

Mailing address

2325 West White Oaks Drive
Springfield, IL 62604-7420
Phone (217) 793-3949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
149-008476ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Psychological Center, LLC Clinical PastSince Jul 25, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023121282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 WEST WHITE OAKS DRIVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "626047420",
            "telephone_number": "217-793-3949",
            "fax_number": "217-793-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 W WHITE OAKS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047419",
            "telephone_number": "217-793-3949",
            "fax_number": "217-793-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DAVID",
        "middle_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "M.A.., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.