Provider Demographics
NPI:1134252950
Name:BROWN, EARL H III (LMHP)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:H
Last Name:BROWN
Suffix:III
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 N 106TH PLZ
Mailing Address - Street 2:#3
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1108
Mailing Address - Country:US
Mailing Address - Phone:402-707-3484
Mailing Address - Fax:
Practice Address - Street 1:5616 N 106TH PLZ
Practice Address - Street 2:#3
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1108
Practice Address - Country:US
Practice Address - Phone:402-707-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100252566-00Medicaid