Provider Demographics
NPI:1376877258
Name:BROWN, RONDA MICHELLE (MA, LPC-MHSP TEMP)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPC-MHSP TEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MALLORY STATION RD STE 205
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2834
Mailing Address - Country:US
Mailing Address - Phone:931-215-0577
Mailing Address - Fax:
Practice Address - Street 1:1324 TROTWOOD AVE STE 6
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4750
Practice Address - Country:US
Practice Address - Phone:931-215-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health