Provider Demographics
NPI:1316561681
Name:BROWN, SHELLY ANN (BS)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:908A W CHANDLER BLVD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-4903
Mailing Address - Country:US
Mailing Address - Phone:480-899-0200
Mailing Address - Fax:480-899-0202
Practice Address - Street 1:908A W CHANDLER BLVD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-4903
Practice Address - Country:US
Practice Address - Phone:480-899-0200
Practice Address - Fax:480-899-0202
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No251B00000XAgenciesCase Management