Provider Demographics
NPI:1568023562
Name:BROWN, JOSELYN ADELE (LGPC)
Entity Type:Individual
Prefix:
First Name:JOSELYN
Middle Name:ADELE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 ENTERPRISE PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4915
Mailing Address - Country:US
Mailing Address - Phone:301-861-8641
Mailing Address - Fax:
Practice Address - Street 1:4545 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3045
Practice Address - Country:US
Practice Address - Phone:301-609-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9642101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health