Provider Demographics
NPI:1518146505
Name:BROWN, JULIE ASNER (MA, LPA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ASNER
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 OLD LAMPLIGHTER WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3427
Mailing Address - Country:US
Mailing Address - Phone:910-232-2301
Mailing Address - Fax:910-251-6572
Practice Address - Street 1:313 WALNUT ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-4067
Practice Address - Country:US
Practice Address - Phone:910-254-4545
Practice Address - Fax:910-254-4557
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1844103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107371Medicaid