Provider Demographics
NPI:1699700336
Name:BROWN, PATRICIA M (LPA, LPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 RANDALL PKWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2829
Mailing Address - Country:US
Mailing Address - Phone:910-791-5719
Mailing Address - Fax:910-799-8180
Practice Address - Street 1:5010 RANDALL PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2829
Practice Address - Country:US
Practice Address - Phone:910-791-5719
Practice Address - Fax:910-799-8180
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4310101YM0800X
NC1149103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
58497OtherCIGNA
58497OtherCIGNA BEHAVIORAL HEALTH
6215980OtherUBH
NC134AHOtherBLUE CROSS BLUE SHIELD
150231OtherCOMPSYCH
299195OtherMHN
NC6107049Medicaid
UNITED HEALTHCAREOther6215980