Provider Demographics
NPI:1942323043
Name:BROWN, JAMES HAROLD (LPC, LPCS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HAROLD
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2647
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-4003
Mailing Address - Country:US
Mailing Address - Phone:803-917-8773
Mailing Address - Fax:803-233-6973
Practice Address - Street 1:2611 RIVER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1749
Practice Address - Country:US
Practice Address - Phone:803-917-8773
Practice Address - Fax:803-233-6973
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4027101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional