Provider Demographics
NPI:1912472820
Name:BROWN, MAEGAN RAE
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 MOUNTAIN CLOSE LN
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-0799
Mailing Address - Country:US
Mailing Address - Phone:704-578-8002
Mailing Address - Fax:
Practice Address - Street 1:322 8TH AVE E
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-3713
Practice Address - Country:US
Practice Address - Phone:828-222-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health