MEDICARE: MRS. CAITLIN RENEE BROWN 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
1	101Y00000X	Counselor	6705	LA

General Provider Information

NPI Number	:	1710581558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAITLIN RENEE BROWN MA, LPC

Provider Business Mailing Address
First Line	:	416 PEAKE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-6048
Country	:	US
Telephone Number	:	337-425-1293
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 PEAKE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-6048
Country	:	US
Telephone Number	:	337-425-1293
Fax Number	:

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

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	11/23/2020

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