Individual
MR. KEITH JOSEPH BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, PCC-S
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
E-4349-SUP
OH
101YM0800X
Mental Health Counselor
E-4349-SUP
OH
101YP2500X
Professional Counselor
Primary
E-4349-SUP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11471436
CAQH PROVIDER IDENTIFICATION NUMBER
OH
Enumeration date
10/12/2006
Last updated
02/14/2012
Update your record
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