Healthcare Provider Details

I. General information

NPI: 1225717333
Provider Name (Legal Business Name): LISA LEILANI BROWN APC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5328 LANIER ISLANDS PKWY STE 103
BUFORD GA
30518-9081
US

IV. Provider business mailing address

3485 MCEVER RD STE 101
GAINESVILLE GA
30504-5542
US

V. Phone/Fax

Practice location:
  • Phone: 770-758-4940
  • Fax:
Mailing address:
  • Phone: 770-758-4940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015544
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC008911
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: