Provider Demographics
NPI:1437745981
Name:BROWNLEY, LISA SIMONE
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:SIMONE
Last Name:BROWNLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 5TH AVE FL 17
Mailing Address - Street 2:#9012
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10175-1799
Mailing Address - Country:US
Mailing Address - Phone:347-552-3069
Mailing Address - Fax:
Practice Address - Street 1:450 ROCKAWAY PKWY APT 3K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3223
Practice Address - Country:US
Practice Address - Phone:347-552-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2024-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103760104100000X
NY0977971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker