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NPI Code Detail

MEDICARE: GERALD C BROWN PHD LCMHC-S

MEDICARE: GERALD C BROWN PHD LCMHC-S
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1396066775
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD C BROWN PHD LCMHC-S
Provider Business Mailing Address
First Line : 19428 FRIDLEY LN
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-9041
Country : US
Telephone Number : 704-492-0713
Fax Number : 704-980-8968
Provider Business Practice Location Address
First Line : 13420 REESE BLVD W
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7925
Country : US
Telephone Number : 704-492-0713
Fax Number : 704-980-8968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2010
Last Update Date : 05/13/2024

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