Provider Demographics
NPI:1982140125
Name:BROWN, JEANNE (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7398 US ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932-1716
Mailing Address - Country:US
Mailing Address - Phone:518-573-1703
Mailing Address - Fax:703-257-7518
Practice Address - Street 1:8273 RIVER STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932-1293
Practice Address - Country:US
Practice Address - Phone:518-873-4175
Practice Address - Fax:518-873-4176
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006768101YM0800X
VA0710103021101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)