Provider Demographics
NPI:1811002256
Name:DIANE D. BROWN, M.ED., L.P.C., P.C.
Entity Type:Organization
Organization Name:DIANE D. BROWN, M.ED., L.P.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-348-6054
Mailing Address - Street 1:500 W 15TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3640
Mailing Address - Country:US
Mailing Address - Phone:405-348-6054
Mailing Address - Fax:405-348-6180
Practice Address - Street 1:500 W 15TH ST STE 2
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3640
Practice Address - Country:US
Practice Address - Phone:405-348-6054
Practice Address - Fax:405-348-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1517101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty