Provider Demographics
NPI:1174929590
Name:BROWN, HEATHER LYNN (LCSW, LCADC, CCS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW, LCADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BRIDLE PATH
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2195
Mailing Address - Country:US
Mailing Address - Phone:518-222-3073
Mailing Address - Fax:
Practice Address - Street 1:761 CUTHBERT BLVD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3417
Practice Address - Country:US
Practice Address - Phone:518-222-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00346300101YA0400X
NJ44SC057666001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)