Provider Demographics
NPI:1811346661
Name:BROWN, NICOLE (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 THIRD AVE
Mailing Address - Street 2:SUITE A #1271
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:917-524-9534
Mailing Address - Fax:
Practice Address - Street 1:50 W 40TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:917-524-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-11
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005910-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health