Provider Demographics
NPI:1568030047
Name:BRAWNER COUNSELING, LLC
Entity Type:Organization
Organization Name:BRAWNER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAWNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-824-0012
Mailing Address - Street 1:31 COUNTY ROAD 3600
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-8162
Mailing Address - Country:US
Mailing Address - Phone:870-824-0012
Mailing Address - Fax:
Practice Address - Street 1:203 MERRIMAN AVE E
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-2943
Practice Address - Country:US
Practice Address - Phone:870-824-0012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1740526367Medicaid