Provider Demographics
NPI:1447634464
Name:BROWN, CHRISTOPHER LANE (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LANE
Last Name:BROWN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 ACADEMY RD NE APT 1018
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7253
Mailing Address - Country:US
Mailing Address - Phone:318-419-9049
Mailing Address - Fax:
Practice Address - Street 1:12200 ACADEMY RD NE APT 1018
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-7253
Practice Address - Country:US
Practice Address - Phone:318-419-9049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-09057104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker