Individual provider Active NPI

Alyssa Joy Brown, PHD, HSPP

  • Counseling Psychologist
  • Indianapolis, IN
National Provider Identifier
1629551858
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
20043345B Issued in IN
Practice address
11216 Fall Creek Rd Ste 9
Indianapolis, IN 46256-9406
Phone
(317) 647-4721
Fax
(317) 647-4398
NPI assigned
Sep 13, 2018
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counseling Psychologist 103TC1900X 20043345B IN Primary
Family Psychologist 103TF0000X

Addresses

Primary practice location

11216 Fall Creek Rd Ste 9
Indianapolis, IN 46256-9406

Mailing address

14672 Edgebrook Dr
Fishers, IN 46040-1361

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20043345BINMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1629551858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14672 EDGEBROOK DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460401361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 FALL CREEK RD STE 9",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462569406",
            "telephone_number": "317-647-4721",
            "fax_number": "317-647-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ALYSSA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PHD, HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20043345B",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.