Provider Demographics
NPI:1689760878
Name:BROWN, BRENT L (LPC)
Entity Type:Individual
Prefix:MR
First Name:BRENT
Middle Name:L
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 1:10951 E SOAPTREE PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-3551
Mailing Address - Country:US
Mailing Address - Phone:520-245-2070
Mailing Address - Fax:520-844-6687
Practice Address - Street 1:1200 N EL DORADO PL
Practice Address - Street 2:SUITE F-620
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4637
Practice Address - Country:US
Practice Address - Phone:520-886-1136
Practice Address - Fax:520-751-7475
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-2167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health