Provider Demographics
NPI:1700988292
Name:BROWN, STEPHAN (PHD, LMHC, NCC,)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHD, LMHC, NCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 620171
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32762-0171
Mailing Address - Country:US
Mailing Address - Phone:407-314-5373
Mailing Address - Fax:
Practice Address - Street 1:1200 OAKLEY SEAVER DR STE 203
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1960
Practice Address - Country:US
Practice Address - Phone:407-314-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6575101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health