Healthcare Provider Details

I. General information

NPI: 1952141509
Provider Name (Legal Business Name): ABE J BROWN III LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

IV. Provider business mailing address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax: 757-301-8803
Mailing address:
  • Phone: 804-207-6737
  • Fax: 757-301-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015917
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: