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

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

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

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.

• 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": "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"
        },
        {
            "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"
        }
    ],
    "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
• 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.