Provider Demographics
NPI:1417150392
Name:BROWN, ELISABETH ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ROSE
Other - Last Name:MOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1023
Mailing Address - Country:US
Mailing Address - Phone:585-415-7255
Mailing Address - Fax:
Practice Address - Street 1:46 PRINCE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1023
Practice Address - Country:US
Practice Address - Phone:585-415-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health