Provider Demographics
NPI:1629522263
Name:BROWN, CHRISTOPHER BROWN (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER BROWN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3490 WHITNEY AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1936
Mailing Address - Country:US
Mailing Address - Phone:203-464-9827
Mailing Address - Fax:
Practice Address - Street 1:3490 WHITNEY AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1936
Practice Address - Country:US
Practice Address - Phone:203-464-9827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional