Provider Demographics
NPI:1073832366
Name:BROWN, JENNIFER MARIE (LADC, PLMHP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LADC, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 WINDHOEK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-1272
Mailing Address - Country:US
Mailing Address - Phone:531-248-3030
Mailing Address - Fax:531-500-2626
Practice Address - Street 1:1600 WINDHOEK DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1272
Practice Address - Country:US
Practice Address - Phone:531-248-3030
Practice Address - Fax:531-500-2626
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE940101YA0400X
NE9639101YM0800X
NE2210101YP2500X
NE1819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026090200Medicaid