Healthcare Provider Details

I. General information

NPI: 1528847803
Provider Name (Legal Business Name): TERRENCE CEDRIC BROWN LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 CHAPEL LAKE DR APT 303
GAMBRILLS MD
21054-1664
US

IV. Provider business mailing address

2607 CHAPEL LAKE DR APT 303
GAMBRILLS MD
21054-1664
US

V. Phone/Fax

Practice location:
  • Phone: 240-305-1975
  • Fax:
Mailing address:
  • Phone: 240-305-1975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP14357
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC17006
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLGP14357
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP14357
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: