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General NPI Number Information
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NPI Number | 1508341389
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Entity Type | Individual
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Provider Name | MICHAEL HAROLD BROWN LMHC, LMFT
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Gender | Male
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 930 ALICIA RD
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City | LAKELAND
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State | FL
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Zip | 33801-2104
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Country | US
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Telephone | 863-680-1950
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Fax | 863-683-4654
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Provider Business Mailing Address
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Address Line | 930 ALICIA RD
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City | LAKELAND
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State | FL
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Zip | 33801-2104
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Country | US
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Telephone | 863-680-1950
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Fax | 863-683-4654
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2114
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8114
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License Number State | FL
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