Provider Demographics
NPI:1164762696
Name:BROWN FAUST, MONIQUE D (PHD LMHC MCAP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:D
Last Name:BROWN FAUST
Suffix:
Gender:F
Credentials:PHD LMHC MCAP
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:
Other - Last Name:BROWN FAUST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LMHC MCAP SAP
Mailing Address - Street 1:800 N SAPODILLA AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3640
Mailing Address - Country:US
Mailing Address - Phone:561-899-9140
Mailing Address - Fax:561-331-2715
Practice Address - Street 1:800 N SAPODILLA AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3640
Practice Address - Country:US
Practice Address - Phone:561-899-9140
Practice Address - Fax:561-331-2715
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMCAP100321101YA0400X
FLMH18952101YM0800X, 101YM0800X
171M00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112621400Medicaid