Provider Demographics
NPI:1205972205
Name:BROWN-RAMSEUR, WANDA MARIE (ED,D, LPC-S, LCAS-S,)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:MARIE
Last Name:BROWN-RAMSEUR
Suffix:
Gender:F
Credentials:ED,D, LPC-S, LCAS-S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79009
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404
Mailing Address - Country:US
Mailing Address - Phone:704-349-3789
Mailing Address - Fax:336-638-9453
Practice Address - Street 1:1451 S ELM EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-2200
Practice Address - Country:US
Practice Address - Phone:704-349-3789
Practice Address - Fax:336-740-1936
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC458101YA0400X
NC7690101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6110558Medicaid