Provider Demographics
NPI:1063151728
Name:BROWN, JANET SUE (LMHC, ATR)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:SUE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:SUE
Other - Last Name:BIRKHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6640 INTECH BLVD STE 195
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-2014
Practice Address - Country:US
Practice Address - Phone:317-295-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004216A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300062783Medicaid