Provider Demographics
NPI:1164017463
Name:BROWN, LASHONDRA (MHT)
Entity Type:Individual
Prefix:
First Name:LASHONDRA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 E RIVER PL STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3442
Mailing Address - Country:US
Mailing Address - Phone:662-516-8668
Mailing Address - Fax:
Practice Address - Street 1:315 N MADISON ST
Practice Address - Street 2:
Practice Address - City:KOSCIUSKO
Practice Address - State:MS
Practice Address - Zip Code:39090-3341
Practice Address - Country:US
Practice Address - Phone:662-516-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker