Healthcare Provider Details

I. General information

NPI: 1144697657
Provider Name (Legal Business Name): LAURA BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 LOUISIANA AVE
BATON ROUGE LA
70802-5820
US

IV. Provider business mailing address

6400 PERKINS RD BLDG D, 1ST FLOOR
BATON ROUGE LA
70808
US

V. Phone/Fax

Practice location:
  • Phone: 225-224-8033
  • Fax: 225-286-1505
Mailing address:
  • Phone: 225-330-0497
  • Fax: 225-330-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1317
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1317
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number1317
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1317
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number1317
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: