Provider Demographics
NPI:1578458121
Name:BROWN, BRIDGETT LAPRICE
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:LAPRICE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1849
Mailing Address - Country:US
Mailing Address - Phone:754-248-2043
Mailing Address - Fax:
Practice Address - Street 1:1776 N PINE ISLAND RD STE 208
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5223
Practice Address - Country:US
Practice Address - Phone:561-503-3059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health