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General NPI Number Information
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NPI Number | 1811460454
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Entity Type | Individual
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Provider Name | JAMAL HASAN BROWN LPC, CSOTP
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Gender | Male
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 6330 NEWTOWN RD STE 615
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City | NORFOLK
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State | VA
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Zip | 23502-4807
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Country | US
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Telephone | 757-838-1894
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Fax | 757-838-1895
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Provider Business Mailing Address
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Address Line | 3516 CANTERBURY DR
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City | PORTSMOUTH
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State | VA
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Zip | 23703-3948
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Country | US
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Telephone | 540-290-3893
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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 | 0701007954
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License Number State | VA
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