Provider Demographics
NPI:1578037396
Name:BROWN, DEVIN ALLEN (CARE COORDINATOR)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:ALLEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:CARE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 DUNCAN DR APT 6
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2055
Mailing Address - Country:US
Mailing Address - Phone:513-923-8026
Mailing Address - Fax:
Practice Address - Street 1:7695 POE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2552
Practice Address - Country:US
Practice Address - Phone:937-247-3200
Practice Address - Fax:937-410-7165
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid