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NPI Code Detail

MEDICARE: PRESTON LEE BROWN CDCA

MEDICARE: PRESTON LEE BROWN CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.187603OH
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1902654585
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRESTON LEE BROWN CDCA
Provider Business Mailing Address
First Line : 624 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44702-1017
Country : US
Telephone Number : 330-493-4553
Fax Number : 330-493-3761
Provider Business Practice Location Address
First Line : 624 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44702-1017
Country : US
Telephone Number : 330-493-4553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2024
Last Update Date : 12/11/2025

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Directions to “ PRESTON LEE BROWN CDCA” Practice Location

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