Provider Demographics
NPI:1811900905
Name:BROWN, DAVID L (LPC MHSP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:LPC MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 SPRATLIN PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:401 HOLSTON DR
Practice Address - Street 2:NOLACHUCKEY MENTAL HEALTH CENTER FRONTIER HEALTH
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743
Practice Address - Country:US
Practice Address - Phone:423-639-1104
Practice Address - Fax:423-636-8365
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC1533101Y00000X
TN1533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4098479OtherMAGELLAN PINNACLE
620582605OtherCARITEN PHP POS
620582605OtherCARITEN PHP HMO
620582605 021OtherTRICARE SOUTH
620582605OtherCARITEN PHP PPO
334969OtherVALUE OPTIONS GROUP
4098479OtherMAGELLAN SUMMIT
620582605OtherCARITEN SENIOR PPO
620582605OtherMENTAL HEALTH NETW
4098479OtherMAGELLAN NAVIGATOR
620582605OtherPHCS
620582605OtherINITIAL GROUP
620582605OtherCARITEN SENIOR HMO
620582605OtherCORPHEALTH
351654200OtherDOL WORKERS COMP
290298OtherMANAGED HEALTH NET
620582605OtherTHREE RIVERS PROVI GROUP
620582605OtherCAR PHP MEDICARE H
620582605OtherCAR PHP LEASE PPO
620582605OtherCARITEN PHP WORKCO