Individual
MR. GLENN TORRE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
448 LAKESHORE PKWY STE 205, ROCK HILL, SC 29730-4264
(803) 328-9600
(803) 329-7141
Mailing address
PO BOX 572, EAST NORTHPORT, NY 11731-0479
(516) 616-3033
(516) 873-8881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
075195
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
303272
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568476885
—
SC
01
—
3339
MEDICARE
SC
Enumeration date
04/20/2007
Last updated
06/25/2020
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