Provider Demographics
NPI:1356051650
Name:BROWN, JEREMY KADEEM (MBA, LMHC,NCC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:KADEEM
Last Name:BROWN
Suffix:
Gender:M
Credentials:MBA, LMHC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N FLAGLER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3429
Mailing Address - Country:US
Mailing Address - Phone:561-642-1000
Mailing Address - Fax:561-804-5629
Practice Address - Street 1:200 CONGRESS PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4618
Practice Address - Country:US
Practice Address - Phone:561-642-1000
Practice Address - Fax:561-804-5629
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21514101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health