Healthcare Provider Details

I. General information

NPI: 1124418439
Provider Name (Legal Business Name): HEATHER JO BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER BROWN

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W WEBSTER AVE STE 301
MUSKEGON MI
49440-1294
US

IV. Provider business mailing address

221 W WEBSTER AVE STE 301
MUSKEGON MI
49440-1294
US

V. Phone/Fax

Practice location:
  • Phone: 517-525-9414
  • Fax:
Mailing address:
  • Phone: 517-525-9414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401012515
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: