Provider Demographics
NPI:1295936490
Name:BROWN, DEON JARMALL I (LCPC,LCADC)
Entity type:Individual
Prefix:MR
First Name:DEON
Middle Name:JARMALL
Last Name:BROWN
Suffix:I
Gender:M
Credentials:LCPC,LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 MAPLE CREST DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1718
Mailing Address - Country:US
Mailing Address - Phone:443-756-5291
Mailing Address - Fax:
Practice Address - Street 1:16 GREENMEADOW DR STE G106
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3200
Practice Address - Country:US
Practice Address - Phone:410-561-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA4221101YA0400X
MDLC1944, LCA4221101YM0800X
MDLC1944101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11ZZDJOtherMAGELLAN HEALTH SERVICES