MEDICARE: DR. CAROLYN BROWN ED.D, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6401002281	MI

General Provider Information

NPI Number	:	1023522190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN BROWN ED.D, LPC

Provider Business Mailing Address
First Line	:	5151 SURFWOOD DR
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-1372
Country	:	US
Telephone Number	:	248-310-3840
Fax Number	:

Provider Business Practice Location Address
First Line	:	8906 COMMERCE RD STE 1
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4484
Country	:	US
Telephone Number	:	248-716-9025
Fax Number	:	248-716-9025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	11/27/2017

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