Provider Demographics
NPI:1336488766
Name:BROWN, JOSEPH (MS, LCMHC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4811
Mailing Address - Country:US
Mailing Address - Phone:603-973-1439
Mailing Address - Fax:
Practice Address - Street 1:22 S MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4483
Practice Address - Country:US
Practice Address - Phone:603-834-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99003227Medicaid
NH99003227Medicaid