Provider Demographics
NPI:1790813053
Name:BROWN, ANGELICA J (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LEGENDS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-9100
Mailing Address - Country:US
Mailing Address - Phone:501-455-4346
Mailing Address - Fax:
Practice Address - Street 1:10 LEGENDS DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-9100
Practice Address - Country:US
Practice Address - Phone:501-455-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9810025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health