Provider Demographics
NPI:1588371645
Name:BROWN, MICHAEL (MS, LPC, CCTP, BCTMH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS, LPC, CCTP, BCTMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 YORK IMPERIAL TRL
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-4839
Mailing Address - Country:US
Mailing Address - Phone:256-525-9027
Mailing Address - Fax:
Practice Address - Street 1:857 YORK IMPERIAL TRL
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-4839
Practice Address - Country:US
Practice Address - Phone:256-525-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3876101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional