Healthcare Provider Details

I. General information

NPI: 1376758375
Provider Name (Legal Business Name): AMANDA N BROWN MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GONZALES RD SW
ALBUQUERQUE NM
87121-2401
US

IV. Provider business mailing address

PO BOX 27561 MEDICAL DEPT#31116
ALBUQUERQUE NM
87125-7561
US

V. Phone/Fax

Practice location:
  • Phone: 505-831-2534
  • Fax:
Mailing address:
  • Phone: 505-873-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0185801
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: