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General NPI Number Information
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NPI Number | 1790699171
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Entity Type | Individual
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Provider Name | ANTHONY M BROWN
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Gender | Male
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 29 S. MALLORY STREET
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City | HAMPTON
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State | VA
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Zip | 23663-7167
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Country | US
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Telephone | 716-704-7547
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Fax |
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Provider Business Mailing Address
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Address Line | 151 OLD BUCKROE RD UNIT 420
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City | HAMPTON
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State | VA
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Zip | 23663-2358
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Country | US
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Telephone | 716-704-7547
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CART-27-RCA001034
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License Number State | CT
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