Provider Demographics
NPI:1295086924
Name:BROWN, WILLIAM KELLY (LPC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KELLY
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 N DRUID HILLS RD NE STE 135
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3118
Mailing Address - Country:US
Mailing Address - Phone:770-828-5441
Mailing Address - Fax:
Practice Address - Street 1:2250 N DRUID HILLS RD NE STE 135
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3118
Practice Address - Country:US
Practice Address - Phone:770-828-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GA008489101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health