Provider Demographics
NPI:1053678607
Name:BROWN, CHRISTOPHER WAYNE (MA, LPC, LPCI)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:BROWN
Suffix:
Gender:M
Credentials:MA, LPC, LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 SOUTHERN WAY LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1786
Mailing Address - Country:US
Mailing Address - Phone:708-705-6294
Mailing Address - Fax:
Practice Address - Street 1:13101 SOUTHERN WAY LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1786
Practice Address - Country:US
Practice Address - Phone:708-705-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66885101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool