Provider Demographics
NPI:1861867871
Name:BROWN, TERESA (LPC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3668
Mailing Address - Country:US
Mailing Address - Phone:281-504-8004
Mailing Address - Fax:
Practice Address - Street 1:101 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3668
Practice Address - Country:US
Practice Address - Phone:281-504-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2016-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71647101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional