Healthcare Provider Details

I. General information

NPI: 1013400738
Provider Name (Legal Business Name): LEE BROWN BSEMS, NRP, PSP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 S UNIVERSITY AVE STE 255B
LITTLE ROCK AR
72204-1650
US

IV. Provider business mailing address

1111 MAIN ST # 2084
CONWAY AR
72032-5455
US

V. Phone/Fax

Practice location:
  • Phone: 501-404-2460
  • Fax: 501-404-9644
Mailing address:
  • Phone: 501-404-2460
  • Fax: 501-404-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number24493
License Number StateAR
# 8
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 11
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number24493
License Number StateAR
# 12
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number24493
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: