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General NPI Number Information
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NPI Number | 1356812762
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Entity Type | Individual
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Provider Name | RUSHIELLE CODI-ANN BROWN MHC
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Gender | Female
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 5805 METROPOLITAN AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-8329
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Country | US
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Telephone | 718-456-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 3223 HERING AVE
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City | BRONX
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State | NY
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Zip | 10469-5003
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Country | US
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Telephone | 718-350-1470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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