Provider Demographics
NPI:1003533811
Name:BROWN, COURTNEY MONET (LMSW)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MONET
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 MARFITT RD APT 17
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6308
Mailing Address - Country:US
Mailing Address - Phone:313-623-6719
Mailing Address - Fax:
Practice Address - Street 1:29623 NORTHWESTERN HWY STE 6
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1076
Practice Address - Country:US
Practice Address - Phone:313-932-5527
Practice Address - Fax:313-731-1991
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-02-06
Deactivation Date:2022-11-21
Deactivation Code:
Reactivation Date:2024-02-06
Provider Licenses
StateLicense IDTaxonomies
MI6801106411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801106411OtherMENTAL/ BEHAVIOR HEALTH