Provider Demographics
NPI:1801333422
Name:BROWN, ARIELLE CHANTAL (LPCA)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:CHANTAL
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 LATROBE DR STE 340
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4823
Mailing Address - Country:US
Mailing Address - Phone:047-364-3989
Mailing Address - Fax:704-364-3974
Practice Address - Street 1:3705 LATROBE DR STE 340
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:047-364-3989
Practice Address - Fax:704-364-3974
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional