Jay Brown, CADAC II
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · North Vernon, IN
NPI 1003387127 · NPPES record last updated Dec 16, 2018
Key facts
- NPI
- 1003387127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CII2134 (IN)
- Practice address
- 203 N State St
North Vernon, IN 47265-2454 - Phone
- (812) 200-2714
- NPI assigned
- Dec 16, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CII2134 | IN | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recover Together, Inc. | Past | Accepting new patients | |
| Recover Together, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CII2134 | IN | Yes |
Addresses
Primary practice location
203 N State St
North Vernon, IN 47265-2454
Mailing address
203 N State St
North Vernon, IN 47265-2454
Phone (812) 200-2714
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CII2134 | Medicaid | IN |
Other providers in North Vernon, IN
- Erin Denise Biehle
- Patricia Bower
- Rachel J Bowers
- Chassie A Broadus
- Erika Layne Brown
- Kathy J Brown
- Ronals P Bulthuis
- William D Burnett
- Louis J Calli Jr.
- Benjamin Charek
All providers in North Vernon, IN · Addiction (Substance Use Disorder) Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.