Provider Demographics
NPI:1205467479
Name:BROWN, SHAWANA J (MS,CAC)
Entity type:Individual
Prefix:MRS
First Name:SHAWANA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS,CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 DELTA RD
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2903
Mailing Address - Country:US
Mailing Address - Phone:504-325-7752
Mailing Address - Fax:
Practice Address - Street 1:128 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5939
Practice Address - Country:US
Practice Address - Phone:985-651-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)