Provider Demographics
NPI:1003107129
Name:BROWN, DWIGHT JR (LIMHP)
Entity Type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 F ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68117-2807
Mailing Address - Country:US
Mailing Address - Phone:402-397-9866
Mailing Address - Fax:402-397-1404
Practice Address - Street 1:2300 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3606
Practice Address - Country:US
Practice Address - Phone:402-474-3322
Practice Address - Fax:402-474-4668
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3983101YM0800X
NE3484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health