Individual
JACOB BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2102 W BETHANY HOME RD, PHOENIX, AZ 85015-1935
(602) 774-4745
Mailing address
4910 E FAIRFIELD ST, MESA, AZ 85205-5346
(480) 329-4621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-23843
AZ
Other
Enumeration date
07/01/2022
Last updated
06/06/2025
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