Provider Demographics
NPI:1558659623
Name:BROWN, SARA MICHELLE (LMHC,CAGS,MS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC,CAGS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EAST ST
Mailing Address - Street 2:311
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4469
Mailing Address - Country:US
Mailing Address - Phone:978-227-8779
Mailing Address - Fax:
Practice Address - Street 1:10 EAST ST
Practice Address - Street 2:311
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4469
Practice Address - Country:US
Practice Address - Phone:978-227-8779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid