Provider Demographics
NPI:1285178996
Name:BROWN, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 DORCHESTER ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418
Mailing Address - Country:US
Mailing Address - Phone:843-974-4686
Mailing Address - Fax:
Practice Address - Street 1:5060 DORCHESTER ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418
Practice Address - Country:US
Practice Address - Phone:843-974-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1043534191Medicaid