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NPI Code Detail

MEDICARE: NIVA BROWN LPC

MEDICARE: NIVA 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
1101YM0800XMental Health Counselor4259AL

General Provider Information

NPI Number : 1902420417
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIVA BROWN LPC
Provider Business Mailing Address
First Line : 5750A SOUTHLAND DR
Second Line :
City : MOBILE
State : AL
Zip : 36693-3316
Country : US
Telephone Number : 251-450-2211
Fax Number : 251-662-7297
Provider Business Practice Location Address
First Line : 4211 GOVERNMENT BLVD
Second Line :
City : MOBILE
State : AL
Zip : 36693-4813
Country : US
Telephone Number : 251-602-6456
Fax Number : 251-602-6489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2020
Last Update Date : 05/31/2020

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