Provider Demographics
NPI:1700947892
Name:BROWN, HEATHER BETH (LPC, ATR, CTC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:BETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC, ATR, CTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E KIRBY ST
Mailing Address - Street 2:SUITE 107E
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-4047
Mailing Address - Country:US
Mailing Address - Phone:313-285-8097
Mailing Address - Fax:
Practice Address - Street 1:15 E KIRBY ST
Practice Address - Street 2:SUITE 107E
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-4047
Practice Address - Country:US
Practice Address - Phone:313-285-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health