Provider Demographics
NPI:1780706101
Name:BROWN, CHANIN MICHELLE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:CHANIN
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RANDALL CASTELL CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8337
Mailing Address - Country:US
Mailing Address - Phone:270-234-9351
Mailing Address - Fax:
Practice Address - Street 1:320 JOAN AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2242
Practice Address - Country:US
Practice Address - Phone:270-769-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health