Healthcare Provider Details

I. General information

NPI: 1316655087
Provider Name (Legal Business Name): SHAWANDA BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 KELWOOD AVE
BATON ROUGE LA
70806-4803
US

IV. Provider business mailing address

1000 CHINABERRY DR
BOSSIER CITY LA
71111-2442
US

V. Phone/Fax

Practice location:
  • Phone: 888-693-4996
  • Fax:
Mailing address:
  • Phone: 225-303-4825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9059
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9059
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: