Healthcare Provider Details

I. General information

NPI: 1598629115
Provider Name (Legal Business Name): PATRICK JAMES BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 TOD PL NW
WARREN OH
44485-2475
US

IV. Provider business mailing address

1212 TOD PL NW
WARREN OH
44485-2475
US

V. Phone/Fax

Practice location:
  • Phone: 330-469-6822
  • Fax: 330-294-5641
Mailing address:
  • Phone: 330-469-6822
  • Fax: 330-294-5641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.194382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: