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 1:1111 MAIN ST # 2084
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5455
Mailing Address - Country:US
Mailing Address - Phone:501-404-2460
Mailing Address - Fax:501-404-9644
Practice Address - Street 1:1123 S UNIVERSITY AVE STE 255B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1650
Practice Address - Country:US
Practice Address - Phone:501-404-2460
Practice Address - Fax:501-404-9644
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 171M00000X, 172V00000X, 174H00000X, 175T00000X, 247ZC0005X, 251K00000X, 251V00000X
AR24493207PE0004X, 261QP0905X, 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
No247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local