MEDICARE: MRS. REBECCA MORGAN BROWN 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	101YP2500X	Professional Counselor	LPC009762	GA

General Provider Information

NPI Number	:	1902347792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA MORGAN BROWN LPC

Provider Business Mailing Address
First Line	:	2336 WISTERIA DR STE 440
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-6160
Country	:	US
Telephone Number	:	770-880-8527
Fax Number	:

Provider Business Practice Location Address
First Line	:	2336 WISTERIA DR STE 440
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-6160
Country	:	US
Telephone Number	:	770-880-8527
Fax Number	:

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

Provider Enumeration Date	:	03/14/2017
Last Update Date	:	12/21/2021

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