Latasha Myjjole' Brown, LCMHCA, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A18308 Issued in NC

Practice address

4830 Matchwood CT
Fayetteville, NC 28306-3934

Phone

(910) 489-6081

NPI assigned

Mar 3, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1063112662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 MATCHWOOD CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063934",
            "telephone_number": "910-489-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 MATCHWOOD CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063934",
            "telephone_number": "910-489-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LATASHA",
        "middle_name": "MYJJOLE'",
        "credential": "LCMHCA, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor",
            "state": "NC",
            "license": "532401",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassidi Logan Brown, PT
• Kenneth Brown, LPCA
• Kiara Brown, BT
• Ladonna Brown
• Lakia Brown
• Laura Marie Brown, SP
• Lekimbra Brown, RN
• Makeshria Brown
• Mato Brown, LCSWA
• Melissa Rachel Brown, OTD, OTR/L

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.