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General NPI Number Information
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NPI Number | 1710186978
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Entity Type | Individual
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Provider Name | PAULA JEAN BROWN LCPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 3607 KOOTENAI ST
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City | BOISE
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State | ID
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Zip | 83705-2250
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Country | US
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Telephone | 208-899-2242
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Fax | 208-338-5440
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Provider Business Mailing Address
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Address Line | 4060 E CHINDEN BLVD
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City | EAGLE
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State | ID
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Zip | 83616-6481
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Country | US
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Telephone | 208-899-2242
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Fax | 208-377-1171
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC 189
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License Number State | ID
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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 | LCPC 189
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC 189
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT 2751
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License Number State | ID
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