Provider Demographics
NPI:1730617309
Name:BROWN, MARQUITTA SONJA (CAS)
Entity type:Individual
Prefix:MS
First Name:MARQUITTA
Middle Name:SONJA
Last Name:BROWN
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 BIRCH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-4016
Mailing Address - Country:US
Mailing Address - Phone:512-537-3152
Mailing Address - Fax:
Practice Address - Street 1:4901 BIRCH CREEK RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-4016
Practice Address - Country:US
Practice Address - Phone:512-537-3152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB0006908101YA0400X
TX2205-0425171M00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator