Individual
MR. LAFAYETTE BROWN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3934 DIXIE HWY STE 102, LOUISVILLE, KY 40216-4163
(502) 287-4176
Mailing address
PO BOX 1454, BARDSTOWN, KY 40004-4454
(502) 496-3300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254539
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100641040
—
KY
05
—
K31710
—
KY
Enumeration date
07/04/2017
Last updated
02/07/2023
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