Provider Demographics
NPI:1154673481
Name:BROWN, VERA (LPC, MED)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC, MED
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:L
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1643 SAVANNAH HWY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-2202
Mailing Address - Country:US
Mailing Address - Phone:843-270-9929
Mailing Address - Fax:
Practice Address - Street 1:27 GAMECOCK AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3398
Practice Address - Country:US
Practice Address - Phone:843-270-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional