=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629186366
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HARVEY BROWN PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 735 S ANN ST
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21231-3402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-522-1181
-----------------------------------------------------
Fax | 410-522-1182
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 960 FELL ST UNIT 507
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21231-3556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-522-1181
-----------------------------------------------------
Fax | 410-522-1182
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number | 01672
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------