Provider Demographics
NPI:1306195607
Name:BROWN, SEQUOIA C (MS LPC LCDC)
Entity Type:Individual
Prefix:MS
First Name:SEQUOIA
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS LPC LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2642 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4847
Mailing Address - Country:US
Mailing Address - Phone:903-706-3083
Mailing Address - Fax:
Practice Address - Street 1:1019 S COLLEGIATE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6309
Practice Address - Country:US
Practice Address - Phone:903-517-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5369101YM0800X
TX72961101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100750190Medicaid