Provider Demographics
NPI:1881630598
Name:BROWN, GREGORY JAMES (LPC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3449
Mailing Address - Country:US
Mailing Address - Phone:828-433-9190
Mailing Address - Fax:828-433-9130
Practice Address - Street 1:78 MEDICAL CENTER DRIVE
Practice Address - Street 2:AUGUSTA HEALTHCARE CROSSROADS
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-213-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005023101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104169Medicaid
43178OtherNBCC