Provider Demographics
NPI:1245415678
Name:BROWN, CHARLENE RINEHART (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:RINEHART
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-3110
Mailing Address - Country:US
Mailing Address - Phone:269-381-8191
Mailing Address - Fax:269-373-0273
Practice Address - Street 1:1460 PROSPECT DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-3110
Practice Address - Country:US
Practice Address - Phone:269-381-8191
Practice Address - Fax:269-373-0273
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health