Provider Demographics
NPI:1871975789
Name:BROWN, DANTE (MS LCPC)
Entity type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 S MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21758-9606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 THOMAS JOHNSON DR STE A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4371
Practice Address - Country:US
Practice Address - Phone:240-575-9688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional