Healthcare Provider Details

I. General information

NPI: 1699048900
Provider Name (Legal Business Name): ANDREA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SHAW AVE
MCKEESPORT PA
15132-2918
US

IV. Provider business mailing address

211 WILLOW DR
MONROEVILLE PA
15146-4552
US

V. Phone/Fax

Practice location:
  • Phone: 412-675-8533
  • Fax: 412-675-8920
Mailing address:
  • Phone: 412-916-9549
  • Fax: 412-675-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008370
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: