Healthcare Provider Details
I. General information
NPI: 1881630598
Provider Name (Legal Business Name): GREGORY JAMES BROWN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/21/2006
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
78 MEDICAL CENTER DRIVE AUGUSTA HEALTHCARE CROSSROADS
FISHERSVILLE VA
22939
US
IV. Provider business mailing address
205 E UNION ST
MORGANTON NC
28655-3449
US
V. Phone/Fax
- Phone: 540-213-2525
- Fax:
- Phone: 828-433-9190
- Fax: 828-433-9130
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 0701005023 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: