MEDICARE: REBECCA SMITS BROWN

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	251B00000X	Case Management Agency
2	101YM0800X	Mental Health Counselor	A19510	NC

General Provider Information

NPI Number	:	1952790859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SMITS BROWN

Provider Business Mailing Address
First Line	:	57 NEWTON DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-9744
Country	:	US
Telephone Number	:	315-271-9105
Fax Number	:

Provider Business Practice Location Address
First Line	:	5716 FAYETTEVILLE RD STE 202
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-9661
Country	:	US
Telephone Number	:	919-748-4610
Fax Number	:

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

Provider Enumeration Date	:	01/15/2015
Last Update Date	:	02/16/2024

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