Provider Demographics
NPI:1932630167
Name:BROWN THERAPY RESOURCES LLC
Entity Type:Organization
Organization Name:BROWN THERAPY RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CADC
Authorized Official - Phone:515-778-8766
Mailing Address - Street 1:974 73RD ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1024
Mailing Address - Country:US
Mailing Address - Phone:515-200-7979
Mailing Address - Fax:515-267-9057
Practice Address - Street 1:974 73RD ST
Practice Address - Street 2:SUITE 24
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1024
Practice Address - Country:US
Practice Address - Phone:515-200-7979
Practice Address - Fax:515-267-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007136251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health