Healthcare Provider Details

I. General information

NPI: 1477473296
Provider Name (Legal Business Name): JADA DANIELLE BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 CARRIAGE WALK PATH
STONE MOUNTAIN GA
30087-5923
US

IV. Provider business mailing address

499 CARRIAGE WALK PATH
STONE MOUNTAIN GA
30087-5923
US

V. Phone/Fax

Practice location:
  • Phone: 678-704-9546
  • Fax:
Mailing address:
  • Phone: 678-704-9546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC017022
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: