MEDICARE: ROBIN BROWN-GORTON MA, MS

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	101YM0800X	Mental Health Counselor	167011	KY

General Provider Information

NPI Number	:	1194388777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN BROWN-GORTON MA, MS

Provider Business Mailing Address
First Line	:	845 SHERWOOD DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2919
Country	:	US
Telephone Number	:	859-396-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 SHERWOOD DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2919
Country	:	US
Telephone Number	:	859-396-4200
Fax Number	:

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

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	06/11/2019

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