Provider Demographics
NPI:1336765429
Name:BROWN, KACIE BARBARA (MED NCC LPC)
Entity Type:Individual
Prefix:
First Name:KACIE
Middle Name:BARBARA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MED NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 N MAIN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1513
Mailing Address - Country:US
Mailing Address - Phone:724-234-1370
Mailing Address - Fax:724-841-0343
Practice Address - Street 1:1610 N MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1513
Practice Address - Country:US
Practice Address - Phone:724-234-1370
Practice Address - Fax:724-841-0343
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional