Provider Demographics
NPI:1144592809
Name:BROWN, CORINTHIAH BERNETTE (BA CAC LLL CMCM)
Entity Type:Individual
Prefix:
First Name:CORINTHIAH
Middle Name:BERNETTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:BA CAC LLL CMCM
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Mailing Address - Street 1:2010 FLORENCE ST APT D
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-1149
Mailing Address - Country:US
Mailing Address - Phone:303-507-1442
Mailing Address - Fax:720-949-0453
Practice Address - Street 1:9520 E JEWELL AVE STE J
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-5713
Practice Address - Country:US
Practice Address - Phone:303-507-1442
Practice Address - Fax:720-949-0453
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO7154101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)