Octavius L Brown, MSCC, LPC, LCADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00627500 Issued in NJ

Practice address

542 S Broadway Apt H19
Pennsville, NJ 08070-2675

Phone

(914) 261-6532

Fax

(856) 759-4467

NPI assigned

Jan 10, 2011

Last updated

Aug 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doc Octavius Mental Health Services

  • Professional Counselor
  • Pennsville, NJ
  • NPI 1780238428

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1811291560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 S BROADWAY APT H19",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702675",
            "telephone_number": "914-261-6532",
            "fax_number": "856-759-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 S BROADWAY APT H19",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702675",
            "telephone_number": "914-261-6532",
            "fax_number": "856-759-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "OCTAVIUS",
        "middle_name": "L",
        "credential": "MSCC, LPC, LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-10",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37PC00627500",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
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        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "25012",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00290600",
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        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
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        {
            "code": "101YM0800X",
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            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00627500",
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        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NJ",
            "license": "37PC00627500",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
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        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
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        },
        {
            "code": "101YP2500X",
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    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lawrence Blackhurst, DDS
• Mitchell Bober, DO
• Christopher Joseph Boston, O.D.
• Braden Dental of South Jersey PC (Dentistry of South Jersey-Pennsville)
• Ronald L Brittner, DPM
• Stacey Camac, LAC
• Bethany Renee Canver, MD
• Michele Danielle Carfiello
• Robert Thaddeaus Chapdelaine, MD
• Christi Erdman, LPC- Coping and Consulting

• Professional Counselor in Pennsville, NJ
• Providers in Pennsville, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.