Provider Demographics
NPI:1598412926
Name:BROWN, RENARTA PATRICE (MS, LCMHC-A)
Entity Type:Individual
Prefix:
First Name:RENARTA
Middle Name:PATRICE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-5982
Mailing Address - Country:US
Mailing Address - Phone:919-614-1305
Mailing Address - Fax:
Practice Address - Street 1:933 SOUTHGATE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-5982
Practice Address - Country:US
Practice Address - Phone:919-614-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional