Healthcare Provider Details

I. General information

NPI: 1982664355
Provider Name (Legal Business Name): STEVEN BROWN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL CENTER DR STE B500
HUNTINGTON WV
25701-3655
US

IV. Provider business mailing address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2266
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1787
  • Fax: 304-691-8711
Mailing address:
  • Phone: 860-612-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2647
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1209
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: