Healthcare Provider Details

I. General information

NPI: 1487517025
Provider Name (Legal Business Name): EDWARD BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 E LANCASTER AVE
SHILLINGTON PA
19607-1364
US

IV. Provider business mailing address

527 E LANCASTER AVE
SHILLINGTON PA
19607-1364
US

V. Phone/Fax

Practice location:
  • Phone: 610-796-8110
  • Fax: 610-796-9130
Mailing address:
  • Phone: 610-796-8110
  • Fax: 610-796-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC002629
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: