Provider Demographics
NPI:1669776605
Name:BROWN, NIKASHIA (LPCI)
Entity type:Individual
Prefix:
First Name:NIKASHIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 KNOX ABBOTT DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-3346
Mailing Address - Country:US
Mailing Address - Phone:803-233-3199
Mailing Address - Fax:803-233-8420
Practice Address - Street 1:989 KNOX ABBOTT DR
Practice Address - Street 2:SUITE 111
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3346
Practice Address - Country:US
Practice Address - Phone:803-233-3199
Practice Address - Fax:803-233-8420
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional