MEDICARE: SHAUNA BROWN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1174194187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAUNA BROWN, LLC

Provider Business Mailing Address
First Line	:	8205 S PRIEST DR UNIT 12542
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-0179
Country	:	US
Telephone Number	:	480-562-7480
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 S ALMA SCHOOL RD STE 8
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-4036
Country	:	US
Telephone Number	:	480-562-7480
Fax Number	:	480-359-2468

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MISS SHAUNA BROWN
Credential	:
Telephone Number	:	480-562-7480

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	05/01/2024

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