Provider Demographics
NPI:1437150166
Name:BROWN, ROBERT LEROY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEROY
Last Name:BROWN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1481 W. 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-988-5292
Mailing Address - Fax:317-988-5203
Practice Address - Street 1:70 WEST HONEYCREEK PARKWAY
Practice Address - Street 2:TERRE HAUTE VA EAST CLINIC
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:812-232-8325
Practice Address - Fax:812-232-8717
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003581A1041C0700X
IN1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000188299OtherANTHEM
IN343416OtherMHN
IN343416OtherMHN