Provider Demographics
NPI:1245566165
Name:BROWN, RALSTON VICTOR (LMHC)
Entity Type:Individual
Prefix:MR
First Name:RALSTON
Middle Name:VICTOR
Last Name:BROWN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 TURKEY LAKE RD STE 1-2
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4707
Mailing Address - Country:US
Mailing Address - Phone:073-705-3574
Mailing Address - Fax:407-801-5139
Practice Address - Street 1:6900 TURKEY LAKE RD STE 1-2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4707
Practice Address - Country:US
Practice Address - Phone:407-370-5357
Practice Address - Fax:407-801-5139
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health