Provider Demographics
NPI:1861509358
Name:BROWN, CARLI ROSLYN
Entity Type:Individual
Prefix:MS
First Name:CARLI
Middle Name:ROSLYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16022 36TH AVE W APT D
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-1435
Mailing Address - Country:US
Mailing Address - Phone:425-308-5676
Mailing Address - Fax:
Practice Address - Street 1:2613 W MARINE VIEW DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3420
Practice Address - Country:US
Practice Address - Phone:425-349-6700
Practice Address - Fax:425-349-6702
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00054801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health