Healthcare Provider Details

I. General information

NPI: 1124500467
Provider Name (Legal Business Name): DARREN GREGORY BROWN LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 UNSER BLVD NE
RIO RANCHO NM
87124-4045
US

IV. Provider business mailing address

10424 SANDY RIDGE RD SW
ALBUQUERQUE NM
87121-3613
US

V. Phone/Fax

Practice location:
  • Phone: 505-896-0928
  • Fax: 505-896-0585
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2022-0636
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: