Healthcare Provider Details

I. General information

NPI: 1326974387
Provider Name (Legal Business Name): ANDALICIA T BROWN LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2432 S CHURCH ST STE B
BURLINGTON NC
27215-5292
US

IV. Provider business mailing address

2432 S CHURCH ST
BURLINGTON NC
27215-5291
US

V. Phone/Fax

Practice location:
  • Phone: 336-494-8856
  • Fax: 336-281-0101
Mailing address:
  • Phone: 336-494-8856
  • Fax: 336-281-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23095
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: