Provider Demographics
NPI:1801149810
Name:BROWN, ANDREW S (LLP - MASTER'S)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:LLP - MASTER'S
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 587
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-0587
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6701 ALONGSIDE LN
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-8633
Practice Address - Country:US
Practice Address - Phone:269-447-2100
Practice Address - Fax:269-447-2170
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015202103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist