Provider Demographics
NPI:1013209352
Name:BROWN, KERI R (PHD)
Entity type:Individual
Prefix:DR
First Name:KERI
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 ODANA RD STE 304
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1123
Mailing Address - Country:US
Mailing Address - Phone:608-370-2345
Mailing Address - Fax:608-338-0686
Practice Address - Street 1:6402 ODANA RD STE 304
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1123
Practice Address - Country:US
Practice Address - Phone:419-989-5532
Practice Address - Fax:608-338-0686
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34949103TC0700X
WI3512-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical