Keith Joseph Brown, PHD, PCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E-4349-SUP Issued in OH

Practice address

141 E Aurora Rd
Suite 1
Northfield, OH 44067-2091

Phone

(330) 467-1825

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1609965110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7680 POND BROOK LN",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440562358",
            "telephone_number": "216-469-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E AURORA RD",
            "address_2": "SUITE 1",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440672091",
            "telephone_number": "330-467-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KEITH",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PHD, PCC-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E-4349-SUP",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E-4349-SUP",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E-4349-SUP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER IDENTIFICATION NUMBER",
            "identifier": "11471436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christine Marilyn Bradley, RN
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• Janelle E Bush, RPH
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• Lisa Marie Carter

• All providers in Northfield, OH
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.