Individual
JASON DANIEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0212049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X630
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/12/2006
Last updated
11/17/2015
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