MEDICARE: MATTHEW JAMES BROWN CASACT 39708

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	39708	NY

General Provider Information

NPI Number	:	1174496335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JAMES BROWN CASACT 39708

Provider Business Mailing Address
First Line	:	8 OLD MILL RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-6514
Country	:	US
Telephone Number	:	914-257-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 OLD MILL RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-6514
Country	:	US
Telephone Number	:	914-257-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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