Healthcare Provider Details

I. General information

NPI: 1558276717
Provider Name (Legal Business Name): AZURE BROWN PSY.D., CSOTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AZURE BARON PSY.D., CSOTP

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2066
MERRIFIELD VA
22116-2066
US

IV. Provider business mailing address

3302 GALLOWS RD
FALLS CHURCH VA
22042-3353
US

V. Phone/Fax

Practice location:
  • Phone: 703-375-9113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003368
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: