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General NPI Number Information
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NPI Number | 1821588773
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Entity Type | Individual
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Provider Name | AVERY BROWN JR. MA, LPC, CAADC
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Gender | Male
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 8333 TOWNSEND ST
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City | DETROIT
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State | MI
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Zip | 48213-2331
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Country | US
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Telephone | 313-579-5824
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Fax | 313-579-5861
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Provider Business Mailing Address
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Address Line | 8333 TOWNSEND ST
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City | DETROIT
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State | MI
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Zip | 48213-2331
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Country | US
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Telephone | 313-579-5824
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Fax | 313-579-5861
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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 | C-01659
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401012256
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License Number State | MI
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