Healthcare Provider Details

I. General information

NPI: 1114283777
Provider Name (Legal Business Name): STEPHANIE BROWNE LPCC, LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 INDIAN SCHOOL RD NE
ALBUQUERQUE NM
87110-4140
US

IV. Provider business mailing address

14212 MARQUETTE DR NE
ALBUQUERQUE NM
87123-1816
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-1362
  • Fax:
Mailing address:
  • Phone: 505-888-1362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0085041
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberB-1477
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: