MEDICARE: JEREMIAH ALAN BROWN ED.S., LSP

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	103TS0200X	School Psychologist	LSP.00799	OH

General Provider Information

NPI Number	:	1548192032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMIAH ALAN BROWN ED.S., LSP

Provider Business Mailing Address
First Line	:	1205 CAMBRIDGE RD
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-2741
Country	:	US
Telephone Number	:	740-622-9433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 CAMBRIDGE RD
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-2741
Country	:	US
Telephone Number	:	740-622-9433
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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