Patrick David Brown, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149025227 Issued in IL

Practice address

223 N Park Ave
Herrin, IL 62948-3149

Phone

(618) 706-9050

NPI assigned

Jun 28, 2023

Last updated

Jun 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 4, 2024 through Mar 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Koen Counseling and Wellness Center

  • Mental Health Counselor
  • Herrin, IL
  • NPI 1952050460
  NPD (past)

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1881371268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 TULIP ROW WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379171667",
            "telephone_number": "618-559-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N PARK AVE",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483149",
            "telephone_number": "618-706-9050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3704 Tulip Row Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379171667",
            "country_code": "US",
            "telephone_number": "618-559-2515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PATRICK",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000008629",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Joyce Branum, OT
• Amanda Laine Brazis, DPM
• Robert Judson Brewer, M.D.
• Daniel R Brown
• Jennifer E Brown
• Russell W Brown, D.O.
• Treg D Brown, MD
• Amber Brumley, FNP-C
• Jesse Paul Bueza, PA-C
• Sarah Burdick

• Clinical Social Worker in Herrin, IL
• Providers in Herrin, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.