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KALISHA KORAN BROWN LCSW
NPI 1396307070
Social Worker - Clinical in Grand Terrace, CA

Active since July 03, 2019PECOS EnrolledAccepts Medicare Assignment
12139 MOUNT VERNON AVE STE 105, GRAND TERRACE, CA 92313(909) 222-0096 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 4, 2026, Mar 22, 2026, Mar 19, 2025 and 7 more (10 updates tracked since 2019).

About Kalisha Koran Brown Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KALISHA KORAN BROWN LCSW (NPI 1396307070) is an individual clinical provider in Grand Terrace, California, licensed in California (99995) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1396307070
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKALISHA KORAN BROWNCredential: LCSW
Location Address12139 MOUNT VERNON AVE STE 105Grand Terrace, CA 92313-5500
Mailing Address3010 S Dakota StPine Bluff, AR 71601-7208 · (909) 222-0096 · Fax (840) 600-3050
Phone(909) 222-0096
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 3, 2019
Last NPPES UpdateMay 4, 202610 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
✔ NPI 1396307070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in CA · 99995✔ Licensed in VA · 0904013051✔ Licensed in TX · 118560✔ Licensed in AR · 27822-C
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
12139 MOUNT VERNON AVE STE 105, Grand Terrace, CA 92313
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Other Names 1

Former Name (1)Kalisha Koran Vault Lcsw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kalisha Koran Brown Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012313133
PECOS Enrollment IDI20210914003840
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92313 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BREAKING CYCLES COUNSELING
Social Worker (Clinical)
12139 MOUNT VERNON AVE STE 105
GRAND TERRACE, CA 92313
San Bernardino County (909) 222-0096

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kalisha Koran Brown's NPI number?

The NPI number for Kalisha Koran Brown is 1396307070. It was assigned to this individual provider in the NPPES registry on July 3, 2019. The provider is also known as Kalisha Koran Vault Lcsw.

Where is Kalisha Koran Brown located?

Kalisha Koran Brown practices at 12139 Mount Vernon Ave Ste 105, Grand Terrace, CA 92313. The listed phone number is (909) 222-0096.

What is Kalisha Koran Brown's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kalisha Koran Brown enrolled in Medicare?

Yes. Kalisha Koran Brown is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kalisha Koran Brown was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.