Provider Demographics
NPI:1659242790
Name:BROWN, ADDISON RAE (PLPC)
Entity type:Individual
Prefix:
First Name:ADDISON
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12718 HILLS RD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-7400
Mailing Address - Country:US
Mailing Address - Phone:816-728-8373
Mailing Address - Fax:
Practice Address - Street 1:4721 S CLIFF AVE STE 200
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6969
Practice Address - Country:US
Practice Address - Phone:913-428-9375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025030518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional