Healthcare Provider Details

I. General information

NPI: 1528441763
Provider Name (Legal Business Name): SYDNEY IEASHIA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2156 WOODDALE BLVD
BATON ROUGE LA
70806-1403
US

IV. Provider business mailing address

17611 CARLISLE AVE
BATON ROUGE LA
70817-5740
US

V. Phone/Fax

Practice location:
  • Phone: 225-416-9625
  • Fax:
Mailing address:
  • Phone: 407-694-3832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: