Provider Demographics
NPI:1013400738
Name:BROWN, LEE (BSEMS, NRP, PSP)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:BSEMS, NRP, PSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 N OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-3513
Mailing Address - Country:US
Mailing Address - Phone:213-218-6172
Mailing Address - Fax:501-710-6881
Practice Address - Street 1:1519 N OLIVE ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-3513
Practice Address - Country:US
Practice Address - Phone:501-404-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 171M00000X, 172V00000X, 174H00000X, 175T00000X, 251K00000X, 251V00000X
AR24493207PE0004X, 146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No175T00000XOther Service ProvidersPeer Specialist
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable