Healthcare Provider Details

I. General information

NPI: 1902717762
Provider Name (Legal Business Name): LAVJONNE-BROWN MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MORNING GLORY DR
DENTON MD
21629-2716
US

IV. Provider business mailing address

108 MORNING GLORY DR
DENTON MD
21629-2716
US

V. Phone/Fax

Practice location:
  • Phone: 302-219-6194
  • Fax:
Mailing address:
  • Phone: 302-219-6194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNA LAHRAE LAVJONNE-BROWN
Title or Position: THERAPIST/OWNER
Credential: LCPC
Phone: 443-421-7774