Healthcare Provider Details

I. General information

NPI: 1548128200
Provider Name (Legal Business Name): HALLIE MARIE BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32730 WALKER RD BUILDING I, STE 5
AVON LAKE OH
44012
US

IV. Provider business mailing address

32730 WALKER RD BUILDING I, STE 5
AVON LAKE OH
44012
US

V. Phone/Fax

Practice location:
  • Phone: 216-633-0371
  • Fax:
Mailing address:
  • Phone: 216-633-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0008275
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: