Provider Demographics
NPI:1285793224
Name:BROWN, ELLIE SOPHIA (MS, LPC)
Entity type:Individual
Prefix:
First Name:ELLIE
Middle Name:SOPHIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:ELI
Other - Middle Name:BERTA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:11303 HUGHES ROAD, OFFICE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089
Mailing Address - Country:US
Mailing Address - Phone:281-317-0021
Mailing Address - Fax:
Practice Address - Street 1:531 FM 359 RD S
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-9006
Practice Address - Country:US
Practice Address - Phone:281-822-4219
Practice Address - Fax:281-375-5134
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional