Provider Demographics
NPI:1669762928
Name:BROWN, ERIE KEYTON III (COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:ERIE
Middle Name:KEYTON
Last Name:BROWN
Suffix:III
Gender:M
Credentials:COUNSELOR
Other - Prefix:
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Mailing Address - Street 1:4119 LEVELSIDE AVE
Mailing Address - Street 2:APT. 15
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4032
Mailing Address - Country:US
Mailing Address - Phone:818-984-2370
Mailing Address - Fax:
Practice Address - Street 1:4119 LEVELSIDE AVE
Practice Address - Street 2:APT. 15
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4032
Practice Address - Country:US
Practice Address - Phone:818-984-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)