MEDICARE: URBAN FLORA PSYCHIATRY AND INTEGRATIVE BEHAVIORAL HEALTH

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1396534509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URBAN FLORA PSYCHIATRY AND INTEGRATIVE BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	4900 OHEAR AVE STE 215
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-5081
Country	:	US
Telephone Number	:	843-323-4689
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 OHEAR AVE STE 215
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-5081
Country	:	US
Telephone Number	:	843-323-4689
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LAQUANDRA BROWN
Credential	:	NP
Telephone Number	:	707-398-1536

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	05/05/2025

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