Provider Demographics
NPI:1336448893
Name:DR. CARYN BROWN INC
Entity type:Organization
Organization Name:DR. CARYN BROWN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRETSIDEN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:219-756-8944
Mailing Address - Street 1:119 W 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7063
Mailing Address - Country:US
Mailing Address - Phone:219-756-8944
Mailing Address - Fax:219-756-8945
Practice Address - Street 1:119 W 86TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7063
Practice Address - Country:US
Practice Address - Phone:219-756-8944
Practice Address - Fax:219-756-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041341A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200227210BMedicaid