Provider Demographics
NPI:1447061874
Name:BROWN LOMAN, STACYE
Entity type:Individual
Prefix:
First Name:STACYE
Middle Name:
Last Name:BROWN LOMAN
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 1:8400 CORPORATE DRIVE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:301-806-7750
Mailing Address - Fax:
Practice Address - Street 1:8400 CORPORATE DRIVE
Practice Address - Street 2:SUITE 435
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-806-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD250116122101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)