Provider Demographics
NPI:1699849778
Name:BROWN, VICKI LOU (MA LPC)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:LOU
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:OTTS
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC
Mailing Address - Street 1:3000 N GARFIELD
Mailing Address - Street 2:SUITE 230 HERITAGE COUNSELING
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705
Mailing Address - Country:US
Mailing Address - Phone:432-685-3787
Mailing Address - Fax:432-685-9998
Practice Address - Street 1:3000 N GARFIELD
Practice Address - Street 2:SUITE 230 HERITAGE COUNSELING
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706
Practice Address - Country:US
Practice Address - Phone:432-685-3787
Practice Address - Fax:432-685-9998
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional