Provider Demographics
NPI:1881999209
Name:BROWN CLINICAL SERVICES
Entity type:Organization
Organization Name:BROWN CLINICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MISS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:704-620-8273
Mailing Address - Street 1:1382 SPRING VIEW CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8849
Mailing Address - Country:US
Mailing Address - Phone:704-620-8273
Mailing Address - Fax:803-324-5111
Practice Address - Street 1:200 E WOODLAWN RD
Practice Address - Street 2:BUILDING 1, SUITE 225 E
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2303
Practice Address - Country:US
Practice Address - Phone:704-620-8273
Practice Address - Fax:803-324-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-15
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty