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Provider Information for 1871245696


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KELLEY BROWN MA, LAPC


Sex: Female

NPI: 1871245696
Last Updated: 2022-01-23
Certification Date: 2022-01-23

Details

NameValue
NPI1871245696
Enumeration Date2022-01-23
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2345 CAROUSEL PARK DR
MORROW, GA 30260-2700
United States

Phone: 678-437-0708 | Fax:
 
Primary Practice Address 135 BRADFORD SQ STE A
FAYETTEVILLE, GA 30215-1902
United States

Phone: 678-489-8072 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalGAAPC007970