MEDICARE: EDITH P BROWN LMHC

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	012651	NY

General Provider Information

NPI Number	:	1528795713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDITH P BROWN LMHC

Provider Business Mailing Address
First Line	:	2076 WRIGHT RD
Second Line	:
City	:	CAZENOVIA
State	:	NY
Zip	:	13035-9303
Country	:	US
Telephone Number	:	315-382-7305
Fax Number	:

Provider Business Practice Location Address
First Line	:	7189 E GENESEE STREET
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066
Country	:	US
Telephone Number	:	315-217-1077
Fax Number	:

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

Provider Enumeration Date	:	08/07/2022
Last Update Date	:	12/23/2023

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