Provider Demographics
NPI:1881916955
Name:BROWN, ANDREA K (MA,LCPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA,LCPC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:K
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,LCPC
Mailing Address - Street 1:651 WEST LAKE STREET
Mailing Address - Street 2:CATHOLIC CHARITIES
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661
Mailing Address - Country:US
Mailing Address - Phone:312-655-7449
Mailing Address - Fax:
Practice Address - Street 1:651 WEST LAKE STREET
Practice Address - Street 2:CATHOLIC CHARITIES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661
Practice Address - Country:US
Practice Address - Phone:312-655-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.001460101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor