MEDICARE: JONATHAN F BROWN MS, CPC-I

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	CI0405	NV

General Provider Information

NPI Number	:	1235532953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN F BROWN MS, CPC-I

Provider Business Mailing Address
First Line	:	8416 OYSTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7072
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8416 OYSTER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7072
Country	:	US
Telephone Number	:	702-813-8204
Fax Number	:

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

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	11/16/2018

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