Healthcare Provider Details

I. General information

NPI: 1811411457
Provider Name (Legal Business Name): REBECCA LYNN BROWN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 WATERMAN AVE
EAST PROVIDENCE RI
02914-1729
US

IV. Provider business mailing address

12 REDWOOD ST
PROVIDENCE RI
02908-2822
US

V. Phone/Fax

Practice location:
  • Phone: 401-434-4999
  • Fax: 401-434-6116
Mailing address:
  • Phone: 401-497-5889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: