Avia Brown, LCSW
Individual provider Active NPI Clinical Social Worker · Wildwood, MO
NPI 1649025529 · NPPES record last updated Apr 23, 2024
Key facts
- NPI
- 1649025529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149.026994 (IL)
- Practice address
- 16619 Willow Glen Dr
Wildwood, MO 63040-1751 - Phone
- (314) 732-9503
- NPI assigned
- Apr 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.026994 | IL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 149.026994 | IL | Yes |
Addresses
Primary practice location
16619 Willow Glen Dr
Wildwood, MO 63040-1751
Mailing address
16619 Willow Glen Dr
Wildwood, MO 63040-1751
Phone (314) 732-9503
Other providers in Wildwood, MO
- Mary K Bland
- Bailee Bonastia
- Betty Bossaller
- Heather Marie Boutwell
- Madison Lee Brocato
- Kimberly E Brown
- Dean Bryan
- Nicole Rae Buesse
- Lisa C Burns
- Taylor Hamilton Bushnell
All providers in Wildwood, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.