Provider Demographics
NPI:1245076827
Name:BROWN, RYAN (CAPRC II, CCHW)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:CAPRC II, CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4265 S A ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-6049
Mailing Address - Country:US
Mailing Address - Phone:765-962-8843
Mailing Address - Fax:
Practice Address - Street 1:1218 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-2100
Practice Address - Country:US
Practice Address - Phone:765-631-0712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor