Provider Demographics
NPI:1801628995
Name:BROWN, KEVIN (MA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:BROWN
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2377
Mailing Address - Country:US
Mailing Address - Phone:931-723-0380
Mailing Address - Fax:
Practice Address - Street 1:806 CLOVER LN
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2377
Practice Address - Country:US
Practice Address - Phone:931-723-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7437OtherTENNESSEE DEPARTMENT OF HEALTH, BOARD FOR LICENSED PROFESSIONAL COUNSELORS