Provider Demographics
NPI:1922473065
Name:BROWN, CAROL LYNN I (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LYNN
Last Name:BROWN
Suffix:I
Gender:F
Credentials:PHD, LP
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:LYNN
Other - Last Name:HULCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6980 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3900
Mailing Address - Country:US
Mailing Address - Phone:414-773-4312
Mailing Address - Fax:414-247-4082
Practice Address - Street 1:6980 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-3900
Practice Address - Country:US
Practice Address - Phone:414-773-4312
Practice Address - Fax:414-247-4082
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4086103T00000X
WI3328-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist