Healthcare Provider Details

I. General information

NPI: 1508178575
Provider Name (Legal Business Name): SHELLI BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 211281
CHULA VISTA CA
91921-1281
US

IV. Provider business mailing address

PO BOX 211281
CHULA VISTA CA
91921-1281
US

V. Phone/Fax

Practice location:
  • Phone: 303-819-3490
  • Fax:
Mailing address:
  • Phone: 303-819-3490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8072
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4100
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: