Healthcare Provider Details

I. General information

NPI: 1548037856
Provider Name (Legal Business Name): ELNORA MALINDA BROWN LPC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 S CARSON AVE
TULSA OK
74119-4610
US

IV. Provider business mailing address

1728 S CARSON AVE
TULSA OK
74119-4610
US

V. Phone/Fax

Practice location:
  • Phone: 918-936-6127
  • Fax:
Mailing address:
  • Phone: 918-936-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13481
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: