Provider Demographics
NPI:1013186386
Name:MARY ANN BROWN & ASSOCIATES
Entity Type:Organization
Organization Name:MARY ANN BROWN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LPC
Authorized Official - Phone:817-599-8040
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-0178
Mailing Address - Country:US
Mailing Address - Phone:817-599-8040
Mailing Address - Fax:817-596-0404
Practice Address - Street 1:802 FORT WORTH HWY
Practice Address - Street 2:STE 102
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4500
Practice Address - Country:US
Practice Address - Phone:817-599-8040
Practice Address - Fax:817-596-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116548203Medicare PIN