Provider Demographics
NPI:1467179887
Name:BROWN, ELLA L (LCPC-C)
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2741
Mailing Address - Country:US
Mailing Address - Phone:207-329-0524
Mailing Address - Fax:
Practice Address - Street 1:1062 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2741
Practice Address - Country:US
Practice Address - Phone:207-329-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health