Provider Demographics
NPI:1679644868
Name:BROWN, DANIEL W (LCMHC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MAIN ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5216
Mailing Address - Country:US
Mailing Address - Phone:802-651-7515
Mailing Address - Fax:802-860-1234
Practice Address - Street 1:3 MAIN ST
Practice Address - Street 2:SUITE 216
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5216
Practice Address - Country:US
Practice Address - Phone:802-651-7515
Practice Address - Fax:802-860-1234
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT63V126OtherMVP
VT1006832Medicaid
VT9151OtherBLUE CROSS BLUE SHIELD VT