Provider Demographics
NPI:1407490626
Name:BROWN, GLORIA DENISHA (LPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:DENISHA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 RANSOME CIR
Mailing Address - Street 2:
Mailing Address - City:WELDON
Mailing Address - State:NC
Mailing Address - Zip Code:27890-1752
Mailing Address - Country:US
Mailing Address - Phone:252-578-7793
Mailing Address - Fax:
Practice Address - Street 1:425 S MAIN ST STE C&D
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-2300
Practice Address - Country:US
Practice Address - Phone:434-634-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional