Provider Demographics
NPI:1497040182
Name:BROWN, SALLIE M (MS PLPC)
Entity Type:Individual
Prefix:MISS
First Name:SALLIE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2925
Mailing Address - Country:US
Mailing Address - Phone:816-561-9494
Mailing Address - Fax:816-561-8199
Practice Address - Street 1:3914 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2925
Practice Address - Country:US
Practice Address - Phone:816-561-9494
Practice Address - Fax:816-561-8199
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011016751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional