Provider Demographics
NPI:1396066775
Name:BROWN, GERALD C (PHD LCMHC-S)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHD LCMHC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19428 FRIDLEY LN
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9041
Mailing Address - Country:US
Mailing Address - Phone:704-492-0713
Mailing Address - Fax:704-980-8968
Practice Address - Street 1:13420 REESE BLVD W
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7925
Practice Address - Country:US
Practice Address - Phone:704-492-0713
Practice Address - Fax:704-980-8968
Is Sole Proprietor?:No
Enumeration Date:2010-06-19
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor