James J Brown, LCSW LPC
Individual provider Active NPI Mental Health Counselor · Jacksonville, TX
NPI 1144217290 · NPPES record last updated Jul 24, 2008
Key facts
- NPI
- 1144217290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LCSW00357 (TX)
- Practice address
- 703 S Main St
Jacksonville, TX 75766-2428 - Phone
- (903) 586-6736
- Fax
- (903) 586-2412
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW00357 | TX | MD | Mental Health Counselor |
| LPC004887 | TX | MD | Mental Health Counselor |
| 357 | TX | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCSW00357 | TX | Yes |
| Mental Health Counselor | 101YM0800X | LPC004887 | TX |
Addresses
Primary practice location
703 S Main St
Jacksonville, TX 75766-2428
Mailing address
703 S Main St
Jacksonville, TX 75766-2428
Phone (903) 586-6736
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 095305101 | Medicaid | TX | |
| 095305103 | Medicaid | TX | |
| 095305104 | Medicaid | TX |
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- Shayna Burdeaux
- Jayanna D Byrd
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- Jacob Martin Cabrera
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All providers in Jacksonville, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2008. 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.