Healthcare Provider Details

I. General information

NPI: 1225291370
Provider Name (Legal Business Name): TRISH MARIE BROWN MA, SCL, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7640 DIXIE HWY STE 155
CLARKSTON MI
48346-2095
US

IV. Provider business mailing address

7640 DIXIE HWY STE 155
CLARKSTON MI
48346-2095
US

V. Phone/Fax

Practice location:
  • Phone: 248-791-9266
  • Fax: 248-392-2601
Mailing address:
  • Phone: 248-791-9266
  • Fax: 248-392-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number246463
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberL1332361
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401010527
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: