Provider Demographics
NPI:1194060533
Name:BROWN, TRISHA MCINTYRE (MA)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:MCINTYRE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-6732
Mailing Address - Country:US
Mailing Address - Phone:864-298-0025
Mailing Address - Fax:864-298-0045
Practice Address - Street 1:20 MARTIN DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-6732
Practice Address - Country:US
Practice Address - Phone:864-298-0025
Practice Address - Fax:864-298-0045
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC78244Medicaid
SC301100Medicaid