Provider Demographics
NPI:1558987107
Name:BROWN, TIARA (LPC)
Entity Type:Individual
Prefix:
First Name:TIARA
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 1:16 CHESTNUT AVE
Mailing Address - Street 2:BUILDING 201 STE 2
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630
Mailing Address - Country:US
Mailing Address - Phone:201-266-0668
Mailing Address - Fax:
Practice Address - Street 1:16 CHESTNUT ST
Practice Address - Street 2:201 STE 2
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1174
Practice Address - Country:US
Practice Address - Phone:201-266-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00658200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional