Provider Demographics
NPI:1073368999
Name:BROWN, KATHLEEN SHEENA (PLPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SHEENA
Last Name:BROWN
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CAMBRIDGE ST APT 1010
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-4630
Mailing Address - Country:US
Mailing Address - Phone:734-788-6773
Mailing Address - Fax:
Practice Address - Street 1:1300 HAMPTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-3163
Practice Address - Country:US
Practice Address - Phone:314-668-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor