Individual provider Active NPI

Monique Brown

  • Mental Health Counselor
  • Waldorf, MD
National Provider Identifier
1851755821
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP4059 Issued in MD
Practice address
2483 Lake Dr
# 132
Waldorf, MD 20601-7223
Phone
(240) 640-0402
NPI assigned
Apr 6, 2016
Reactivated
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP4059 MD Primary

Addresses

Primary practice location

2483 Lake Dr
# 132
Waldorf, MD 20601-7223

Mailing address

2483 Lake Dr
# 132
Waldorf, MD 20601-7223
Phone (240) 640-0402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP4059MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MSB Counseling Services, Inc Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1851755821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 LAKE DR",
            "address_2": "# 132",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206017223",
            "telephone_number": "240-640-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 LAKE DR",
            "address_2": "# 132",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206017223",
            "telephone_number": "240-640-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "deactivation_date": "2019-11-14",
        "reactivation_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP4059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.