Provider Demographics
NPI:1871807842
Name:BROWN, JAN M (CADC)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:CADC
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 H
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04631-0909
Mailing Address - Country:US
Mailing Address - Phone:207-853-6001
Mailing Address - Fax:207-853-4031
Practice Address - Street 1:30 BOYNTON ST
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:ME
Practice Address - Zip Code:04631-1306
Practice Address - Country:US
Practice Address - Phone:207-853-6001
Practice Address - Fax:207-853-4031
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor