Provider Demographics
NPI:1134387574
Name:BROWN, DOROTHY MARIE (LMHC, LAC)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC, LAC
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:MARIE
Other - Last Name:MCNEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9100 S DADELAND BLVD STE 1500
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7816
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:10775 PIONEER TRL STE 215
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0234
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000430A101YA0400X
FLICADC.0120804101YA0400X
FLMCAP.0011176101YA0400X
FLCMHP.0050177101YM0800X
IN39004099A101YM0800X
1-00-0311103K00000X
FLMH14926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHH37868OtherFLORIDA DEPT. OF STATE; NOTARY
INTS0001655OtherOUT OF STATE TELEHEALTH PROVIDER
FL86000430AOtherFLORIDA CERTIFICATION BOARD; TELEHEALTH PRACTITIONER
FL020489900Medicaid
FL112093200Medicaid
FL3996WOtherFLORIDA CERTIFICATION BOARD
B0103211038OtherBREINING INSTITUTE