Active NPI
Shaniequa Brown, LADC
- Addiction (Substance Use Disorder) Counselor
- West Haven, CT
National Provider Identifier
1548633183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1170
- Practice address
- 153 Bull Hill LN
Suite 321
West Haven, CT 06516-3928 - Phone
- (999) 999-9999
- NPI assigned
- Nov 4, 2015
- Last updated
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1170 | CT | Primary |
Addresses
Primary practice location
153 Bull Hill LN
Suite 321
West Haven, CT 06516-3928
Mailing address
153 Bull Hill LN
Suite 321
West Haven, CT 06516-3928
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008062470 | Other | CT | BROWN MEDICAID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1170 | CT | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1548633183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 BULL HILL LN",
"address_2": "SUITE 321",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065163928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 BULL HILL LN",
"address_2": "SUITE 321",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065163928",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHANIEQUA",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-04",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "1170",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BROWN MEDICAID #",
"identifier": "008062470",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.