Healthcare Provider Details

I. General information

NPI: 1669324760
Provider Name (Legal Business Name): BRIAN BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 MANOR AVE SW
CONCORD NC
28025-5711
US

IV. Provider business mailing address

265 MANOR AVE SW
CONCORD NC
28025-5711
US

V. Phone/Fax

Practice location:
  • Phone: 704-788-4726
  • Fax: 980-248-1182
Mailing address:
  • Phone: 704-788-4726
  • Fax: 980-248-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: