Provider Demographics
NPI:1902238249
Name:BROWN, LORI K (MA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LEXINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-2423
Mailing Address - Country:US
Mailing Address - Phone:612-584-1460
Mailing Address - Fax:952-758-4740
Practice Address - Street 1:101 LEXINGTON AVE S
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-2423
Practice Address - Country:US
Practice Address - Phone:612-584-1460
Practice Address - Fax:952-758-4740
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)