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NPI Code Detail

MEDICARE: NICOLE BROWNING MA, LPC

MEDICARE: NICOLE BROWNING MA, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor178.005312IL
2101YP2500XProfessional Counselor180.007401IL
3101YP2500XProfessional Counselor2012012906MO

General Provider Information

NPI Number : 1457582405
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE BROWNING MA, LPC
Provider Business Mailing Address
First Line : 4041 LOCKPORT DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2130
Country : US
Telephone Number : 636-734-0953
Fax Number :
Provider Business Practice Location Address
First Line : 1050 CROWN POINTE PKWY STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30338-7702
Country : US
Telephone Number : 678-534-7625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2009
Last Update Date : 08/09/2022

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