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NPI Code Detail

MEDICARE: TRISHA BROWN

MEDICARE:   TRISHA  BROWN
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
1101YP2500XProfessional CounselorLPC008409GA

General Provider Information

NPI Number : 1407211139
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISHA BROWN
Provider Business Mailing Address
First Line : 2107 N DECATUR RD # 183
Second Line :
City : DECATUR
State : GA
Zip : 30033-5305
Country : US
Telephone Number : 470-588-7139
Fax Number : 470-592-6077
Provider Business Practice Location Address
First Line : 4991 LONGVIEW WALK
Second Line :
City : DECATUR
State : GA
Zip : 30035-4189
Country : US
Telephone Number : 470-588-7139
Fax Number : 470-592-6077
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2015
Last Update Date : 11/08/2021

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Directions to “ TRISHA BROWN ” Practice Location

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