Provider Demographics
NPI:1063879351
Name:BROWN, BARBARA (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 MELBURY RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3286
Mailing Address - Country:US
Mailing Address - Phone:901-497-8627
Mailing Address - Fax:
Practice Address - Street 1:6812 CRUMPLER BLVD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1900
Practice Address - Country:US
Practice Address - Phone:901-497-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health