Provider Demographics
NPI:1811192974
Name:BROWN, GEORGE EDWARD (MED, LPC, CRT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:EDWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:MED, LPC, CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WERNER CT
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1326
Mailing Address - Country:US
Mailing Address - Phone:307-233-4210
Mailing Address - Fax:307-233-4213
Practice Address - Street 1:800 WERNER CT
Practice Address - Street 2:SUITE 235
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1326
Practice Address - Country:US
Practice Address - Phone:307-233-4210
Practice Address - Fax:307-233-4213
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYBRO314530OtherBCBS OF WYOMING