Provider Demographics
NPI:1609616978
Name:BROWN, CAROL DENISE (MDIV, MS, LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:DENISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MDIV, MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-3002
Mailing Address - Country:US
Mailing Address - Phone:404-432-3118
Mailing Address - Fax:
Practice Address - Street 1:10700 MEDLOCK BRIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-8455
Practice Address - Country:US
Practice Address - Phone:404-383-8036
Practice Address - Fax:404-745-8565
Is Sole Proprietor?:No
Enumeration Date:2024-05-25
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional