Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCA4221 | MD |
N | 101YM0800X | Mental Health Counselor | LC1944, LCA4221 | MD |
N | 101YP1600X | Pastoral Counselor | LC1944 | MD |
NPI | 1295936490 |
---|---|
Provider Name | Mr. Deon Jarmall Brown I |
First Address | Baltimore, MD 21220-1718 |
Second Address | Lutherville Timonium, MD 21093-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11ZZDJ | MAGELLAN HEALTH SERVICES (01) | MD |