Provider Demographics
NPI:1972203990
Name:BROWN, KRISTLE ME CHELLE (LCAS)
Entity Type:Individual
Prefix:
First Name:KRISTLE
Middle Name:ME CHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 CAMPBELLS MILL RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:VA
Mailing Address - Zip Code:24521-4311
Mailing Address - Country:US
Mailing Address - Phone:434-942-2992
Mailing Address - Fax:
Practice Address - Street 1:832 CAMPBELLS MILL RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:VA
Practice Address - Zip Code:24521-4311
Practice Address - Country:US
Practice Address - Phone:434-942-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)