Charles Nicholas Brown, LPCC

Individual provider Active NPI Mental Health Counselor · Newport, KY

NPI 1013350867 · NPPES record last updated Aug 19, 2025

Key facts

NPI
1013350867
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
164140 (KY)
Practice address
200 W 3Rd St
Newport, KY 41071-1814
Phone
(859) 301-5901
Fax
(859) 301-5940
NPI assigned
Apr 11, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group Inc (803 clinicians)

Practice addresses (Care Compare)

200 W 3Rd St
Newport, KY 41071-1814
Phone (859) 578-5662

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240313000180 KY Practitioner - Mental Health Counselor 7517268030 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
87001759AINMDMental Health Counselor
164140KYMDMental Health Counselor
276436KYMDMental Health Counselor
LICDC.162601OHMDMental Health Counselor
1591KYMDProfessional Counselor

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Mental Health Current
since Jan 28, 2024
Accepting new patients
Summit Medical Group, Inc. Current
since Jan 28, 2024
Accepting new patients

Locations

6105 1st Financial Dr
Burlington, KY 41005
Phone (859) 525-1846

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

200 W 3rd St
Newport, KY 41071
Phone (859) 212-0175

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Networks

  • KY PPO C-SNP
  • KY PPO
  • OH PPO
  • TN PPO

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCPCC00218319 KY
Mental Health Counselor 101YM0800X 276436 KY
Mental Health Counselor 101YM0800X 87001759A IN
Mental Health Counselor 101YM0800X LICDC.162601 OH
Professional Counselor 101YP2500X LPCPCC00218319 KY
Professional Counselor 101YP2500X 1591 KY
Mental Health Counselor 101YM0800X 164140 KY Yes

Addresses

Primary practice location

200 W 3Rd St
Newport, KY 41071-1814

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Other identifiers

IdentifierTypeStateIssuer
610661458OtherKYTAX ID
611300608OtherKYTAX IDENTIFICATION NUMBER
0155170MedicaidOH
7100333760MedicaidKY

Other names

  • Jordan Brown Other name

Other providers in Newport, KY

All providers in Newport, KY · Mental Health Counselor in Kentucky

Sources for this page

Verify at the official NPI Registry.