MEDICARE: MISS SHAUNA BROWN LPC

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	14459	AZ

General Provider Information

NPI Number	:	1407277676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHAUNA BROWN LPC

Provider Business Mailing Address
First Line	:	8205 S. PRIEST DR. UNIT 12542
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284
Country	:	US
Telephone Number	:	480-562-7480
Fax Number	:	520-421-2708

Provider Business Practice Location Address
First Line	:	2950 S ALMA SCHOOL RD STE 8
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-4036
Country	:	US
Telephone Number	:	480-562-7480
Fax Number	:	480-359-2468

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

Provider Enumeration Date	:	12/13/2013
Last Update Date	:	05/01/2024

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