Provider Demographics
NPI:1952969602
Name:BROWN, AMIE (LMHC, LCPC)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3773 W 5TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-8746
Mailing Address - Country:US
Mailing Address - Phone:509-867-8544
Mailing Address - Fax:208-619-4497
Practice Address - Street 1:3773 W 5TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-8746
Practice Address - Country:US
Practice Address - Phone:509-867-8544
Practice Address - Fax:208-619-4497
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9087101YP2500X
WALH60914759101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLCPC9087OtherLICENSED CLINICAL PROFESSIONAL COUNSELOR