Provider Demographics
NPI:1417165598
Name:BROWN, DARRELL D (MS)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:DARRELL
Other - Middle Name:D
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:3833 N MERIDIAN ST STE 320
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4059
Mailing Address - Country:US
Mailing Address - Phone:317-506-2251
Mailing Address - Fax:317-335-9043
Practice Address - Street 1:3833 N MERIDIAN ST STE 320
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4059
Practice Address - Country:US
Practice Address - Phone:317-506-2251
Practice Address - Fax:317-335-9043
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health