Individual
STAR SULLIVAN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
7160 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9266
(662) 536-3132
Mailing address
814 JEFFERSON AVE STE 102, MEMPHIS, TN 38105-5041
(901) 222-9404
(901) 222-9337
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
P011078
NC
Other
Enumeration date
11/10/2016
Last updated
12/05/2023
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