Brown Behavioral Health Services

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BROWN BEHAVIORAL HEALTH SERVICES

Practice address

793 Tennessee St
Bolivar, TN 38008-2441

Phone

(731) 228-9068

Fax

(901) 425-9773

NPI assigned

Apr 5, 2022

Last updated

Jul 17, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Avanti Cross-Brown, DNP, PMHNP-, CARN-APNPI 1144846767

Title

Ceo

Phone

(731) 228-9068

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699416636. Details of each certification follow.

• CCN 888926 Rural health clinic · Active · Details

Rural health clinic certification: CCN 888926

Legal name

BROWN BEHAVIORAL HEALTH SERVICES

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Feb 6, 2025

Last certification

Feb 6, 2025

Ownership / control type

1A

Organization structure

LLCProprietary

Incorporated

Mar 20, 2022 in TN

Enrollment address

793 Tennessee St
Ste a
Bolivar, TN 38008-2441

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: contact@brownbehavioral.com

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Avanti Cross-Brown, DNP, PMHNP, CARN-AP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolivar, TN
  • NPI 1144846767

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

  CMS ownership

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Avanti Cross-Brown, DNP, PMHNP, CARN-AP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolivar, TN
  • NPI 1144846767
  Medicare reassignment Care Compare group NPD Authorized official
• Kayla Williams, APRN, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolivar, TN
  • NPI 1538906573

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jessica Lynn Allen, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolivar, TN
  • NPI 1376205617
  Medicare reassignment NPD
• Starlett Renee Armstrong, LCSW

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1487849931
  Medicare reassignment NPD
• Kelley Catherine Lewin, LCSW

  • Clinical Social Worker
  • Collierville, TN
  • NPI 1851777270
  Medicare reassignment NPD
• Peggy Clark, LMSW

  • Clinical Social Worker
  • Bolivar, TN
  • NPI 1356184006
  NPD
• Tatyana Demato, MSW

  • Clinical Social Worker
  • Bolivar, TN
  • NPI 1144190315
  NPD
• Susanna Reid

  • Clinical Social Worker
  • Bolivar, TN
  • NPI 1053281212
  NPD
• Brittany Tillis, LMSW

  • Clinical Social Worker
  • Bolivar, TN
  • NPI 1659113348
  NPD
• Broderick Webster Sr., LPC

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1124897996
  NPD
• Bruce Wilks, LADAC

  • Addiction (Substance Use Disorder) Counselor
  • Bolivar, TN
  • NPI 1376389882
  NPD
• Joselyn Wilson, PSYCHOLOGY

  • Counseling Psychologist
  • Bolivar, TN
  • NPI 1487465282

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1699416636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 TENNESSEE ST",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082441",
            "telephone_number": "731-228-9068",
            "fax_number": "901-425-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 TENNESSEE ST",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082441",
            "telephone_number": "731-228-9068",
            "fax_number": "901-425-9773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "623 Moss Ln",
            "address_purpose": "LOCATION",
            "city": "Bolivar",
            "state": "TN",
            "postal_code": "380081074",
            "country_code": "US",
            "telephone_number": "901-864-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9851 Highway 178 Ste B",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386543214",
            "country_code": "US",
            "telephone_number": "731-228-9068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3694 Iron Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386545566",
            "country_code": "US",
            "telephone_number": "731-228-9068",
            "fax_number": "901-425-9773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROWN BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "CROSS-BROWN",
        "authorized_official_first_name": "AVANTI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "731-228-9068",
        "authorized_official_credential": "DNP, PMHNP-, CARN-AP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@brownbehavioral.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "623 Moss Ln",
            "city": "Bolivar",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380081074",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@brownbehavioral.com",
            "affiliation": "N",
            "address_1": "793 Tennessee St",
            "city": "Bolivar",
            "state": "TN",
            "country_code": "US",
            "postal_code": "380082441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bolivar Operator LLC (Pine Meadows Healthcare)
• Ethel Annette Bowker, RNES
• Lafonda Boyd, BLS
• Mary Brinkley, C.O.T.A.
• Samantha Elizabeth Brock
• Latreace S Brown
• Kimberly Bryant-Holman, PHARM D
• Renita Gail Bufford-Jones
• Mary Jean Bufford, LCSW
• Michael Aaron Burks, PHARM.D.

• Rural Health Clinic/Center in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.