Provider Demographics
NPI:1134983067
Name:BROWN, VIVIA MARIA (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:VIVIA
Middle Name:MARIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20162 BUSHWICK FALLS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-2284
Mailing Address - Country:US
Mailing Address - Phone:337-378-2768
Mailing Address - Fax:
Practice Address - Street 1:20162 BUSHWICK FALLS DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-2284
Practice Address - Country:US
Practice Address - Phone:337-378-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93793101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor