Provider Demographics
NPI:1457319873
Name:BROWN, AUDREE (LPC)
Entity Type:Individual
Prefix:
First Name:AUDREE
Middle Name:
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 1:510 S SYCAMORE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5044
Mailing Address - Country:US
Mailing Address - Phone:804-861-0700
Mailing Address - Fax:804-863-4626
Practice Address - Street 1:510 S SYCAMORE ST
Practice Address - Street 2:SUITE F
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5044
Practice Address - Country:US
Practice Address - Phone:804-861-0700
Practice Address - Fax:804-863-4626
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health