Provider Demographics
NPI:1710678156
Name:BROWN, RUFUS MCKINNLEY II (LADC)
Entity Type:Individual
Prefix:MR
First Name:RUFUS
Middle Name:MCKINNLEY
Last Name:BROWN
Suffix:II
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 HENNEPIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3470
Mailing Address - Country:US
Mailing Address - Phone:612-353-5639
Mailing Address - Fax:
Practice Address - Street 1:3255 HENNEPIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3470
Practice Address - Country:US
Practice Address - Phone:612-353-5639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301802101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)