Provider Demographics
NPI:1477351500
Name:BROWN, LATONYA V (CADAC LL ,)
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:V
Last Name:BROWN
Suffix:
Gender:
Credentials:CADAC LL ,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 SYDNEY LN
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7683
Mailing Address - Country:US
Mailing Address - Phone:317-627-0064
Mailing Address - Fax:
Practice Address - Street 1:8125 SYDNEY LN
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7683
Practice Address - Country:US
Practice Address - Phone:317-627-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC2-51455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)