Healthcare Provider Details

I. General information

NPI: 1043011679
Provider Name (Legal Business Name): KAREN BROWER MAADC1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S ASH ST
NEVADA MO
64772-3222
US

IV. Provider business mailing address

815 S ASH ST
NEVADA MO
64772-3222
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-8352
  • Fax: 417-667-9216
Mailing address:
  • Phone: 417-667-8352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number18753
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: