=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043727852
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIENNE N BROWN LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2018
-----------------------------------------------------
Last Update Date | 07/09/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7419 S KIRKWOOD RD STE A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77072
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-356-8165
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4915 HORNBEAM LN
-----------------------------------------------------
City | ROSENBERG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77471-1558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-721-3417
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 74500
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------