Provider Demographics
NPI:1154443604
Name:BROWN, CHRISTOPHER (LMFT, CCLS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:LMFT, CCLS
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT, CCLS
Mailing Address - Street 1:5301 WILLIAMSON RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-1449
Mailing Address - Country:US
Mailing Address - Phone:540-744-2933
Mailing Address - Fax:540-215-7339
Practice Address - Street 1:5301 WILLIAMSON RD STE B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-1449
Practice Address - Country:US
Practice Address - Phone:540-744-2933
Practice Address - Fax:540-215-7339
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48561106H00000X
VA0717001496106H00000X
NMCTB-2022-0177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3001670117Medicaid