Active NPI
Andrew Brown, MS/LPCC
- Professional Counselor
- Moraine, OH
National Provider Identifier
1083137657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.2001792
- Practice address
- 3095 Kettering Blvd
Moraine, OH 45439-1983 - Phone
- (937) 293-8300
- NPI assigned
- Jul 25, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C1200461 | OH | |
| Professional Counselor | 101YP2500X | E.2001792 | OH | Primary |
Addresses
Primary practice location
3095 Kettering Blvd
Moraine, OH 45439-1983
Mailing address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250528001990 | OH | Practitioner - Mental Health Counselor | 7416476999 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1200461 | OH | MD | Mental Health Counselor |
| E.2001792 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Community Inc. | Current | Accepting new patients | |
| South Community Inc | Current | Accepting new patients |
Locations
1349 E Stroop Rd
Kettering, OH 45429
Phone (937) 293-1115
3095 Kettering Blvd
Moraine, OH 45439
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Moraine, OH
- NPI 1427289818
OH
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Moraine, OH
- NPI 1639128176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1083137657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3095 KETTERING BLVD",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391983",
"telephone_number": "937-293-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3095 KETTERING BLVD",
"city": "MORAINE",
"state": "OH",
"postal_code": "454391983",
"telephone_number": "937-293-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "ANDREW",
"credential": "MS/LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-25",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C1200461",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2001792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moraine, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.