Individual provider Active NPI

Pamela S Brown, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1255492005
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002433 Issued in NC
Practice address
4500 Simsbury Rd Apt B
Charlotte, NC 28226-5524
Phone
(980) 875-9380
NPI assigned
Dec 13, 2006
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2013

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 C002433 NC Primary

Addresses

Primary practice location

4500 Simsbury Rd Apt B
Charlotte, NC 28226-5524

Mailing address

4500 Simsbury Rd Apt B
Charlotte, NC 28226-5524
Phone (980) 875-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000657 NC Practitioner - Clinical Social Worker 4587665252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C002433NCMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1255492005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SIMSBURY RD APT B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265524",
            "telephone_number": "980-875-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SIMSBURY RD APT B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265524",
            "telephone_number": "980-875-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PAMELA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.