Provider Demographics
NPI:1316821820
Name:BROWN-BARR, KETURAH (LSW, MSW, PEL)
Entity type:Individual
Prefix:
First Name:KETURAH
Middle Name:
Last Name:BROWN-BARR
Suffix:
Gender:F
Credentials:LSW, MSW, PEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18501 MAPLE CREEK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6779
Mailing Address - Country:US
Mailing Address - Phone:708-798-4200
Mailing Address - Fax:
Practice Address - Street 1:18501 MAPLE CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-6779
Practice Address - Country:US
Practice Address - Phone:708-798-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL25277001041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool