Provider Demographics
NPI:1982202636
Name:BROWN, ALICIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCMHC
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 208
Mailing Address - Street 2:
Mailing Address - City:CLIMAX
Mailing Address - State:NC
Mailing Address - Zip Code:27233-0208
Mailing Address - Country:US
Mailing Address - Phone:336-601-4551
Mailing Address - Fax:
Practice Address - Street 1:4811 PLEASANT GARDEN RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GARDEN
Practice Address - State:NC
Practice Address - Zip Code:27313-9273
Practice Address - Country:US
Practice Address - Phone:336-601-4551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health