Provider Demographics
NPI:1790902492
Name:BRAWNER, ALISON JANE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:JANE
Last Name:BRAWNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0210
Mailing Address - Country:US
Mailing Address - Phone:417-889-6506
Mailing Address - Fax:
Practice Address - Street 1:380 E HWY CC
Practice Address - Street 2:STE A105
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65804
Practice Address - Country:US
Practice Address - Phone:417-725-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003019059101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional