MEDICARE: MS. LAFRESHIA BROWN LPCC, 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	A8110712	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	B1208310930	CA
3	101YP2500X	Professional Counselor	83946	TX
4	101YP2500X	Professional Counselor	4943	CA

General Provider Information

NPI Number	:	1730514605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAFRESHIA BROWN LPCC, LPC

Provider Business Mailing Address
First Line	:	1271 WASHINGTON AVE # 730
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-3646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1271 WASHINGTON AVE # 730
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-3646
Country	:	US
Telephone Number	:	510-730-5101
Fax Number	:

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

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	08/23/2021

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