1164912846 NPI number — ANN-MARIE BROWN M.ED, MFT, AC, LPC

Table of content: ANN-MARIE BROWN M.ED, MFT, AC, LPC (NPI 1164912846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164912846 NPI number — ANN-MARIE BROWN M.ED, MFT, AC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ANN-MARIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED, MFT, AC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164912846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
213 WINDSOR AVE FL 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06095-4540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-726-3442
Provider Business Mailing Address Fax Number:
860-461-0659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE CONGRESS STREET
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-461-0504
Provider Business Practice Location Address Fax Number:
860-461-0659
Provider Enumeration Date:
05/17/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  003294 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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