Provider Demographics
NPI:1740293265
Name:BROWN, LAWRENCE OWEN (PHD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:OWEN
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-4030
Mailing Address - Country:US
Mailing Address - Phone:914-833-2133
Mailing Address - Fax:914-833-2133
Practice Address - Street 1:71 BEACH AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-4030
Practice Address - Country:US
Practice Address - Phone:914-833-2133
Practice Address - Fax:914-833-2133
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4640103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical