Organization Active NPI

Sue Brown, LLC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1992174999
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13617 Issued in MD
Legal business name
SUE BROWN, LLC
Practice address
711 W 40TH St Ste 358
Baltimore, MD 21211-2111
Phone
(443) 350-0813
Fax
(484) 805-7166
NPI assigned
Sep 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Susan Brown, LCSW-CNPI 1144629189
Title
Owner
Phone
(443) 350-0813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 13617 MD Primary

Addresses

Primary practice location

711 W 40TH St Ste 358
Baltimore, MD 21211-2111

Mailing address

711 W 40TH St Ste 358
Baltimore, MD 21211-2111
Phone (443) 350-0813

Other identifiers 2

IdentifierTypeStateIssuer
815718MedicaidMD
13523036OtherMDCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160322002653 MD Part B Supplier - Clinic/Group Practice 2365749199 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1992174999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST STE 358",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112111",
            "telephone_number": "443-350-0813",
            "fax_number": "484-805-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST STE 358",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112111",
            "telephone_number": "443-350-0813",
            "fax_number": "484-805-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE BROWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-20",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-350-0813",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "815718",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13523036",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.