Jacqueline Diana Brown

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005592 Issued in NY

Practice address

7210 112TH St Ofc B
Forest Hills, NY 11375-5467

Phone

(917) 804-2133

NPI assigned

Aug 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1871017814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17860 WEXFORD TER APT 2H",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323019",
            "telephone_number": "917-804-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 112TH ST OFC B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755467",
            "telephone_number": "917-804-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7405 Metropolitan Ave Apt 2F",
            "address_purpose": "LOCATION",
            "city": "Middle Village",
            "state": "NY",
            "postal_code": "113792636",
            "country_code": "US",
            "telephone_number": "917-804-2133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 E Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115811240",
            "country_code": "US",
            "telephone_number": "917-809-6136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 W 23rd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100112599",
            "country_code": "US",
            "telephone_number": "917-809-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACQUELINE",
        "middle_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005592",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maxine L Brooks, CNM, NP
• Yvette Brooks, R.N.
• Fay Brown, R.D.H.
• Jaleesa Brown
• Kiani Nayo Brown
• Njelle Brown
• Rosalind Brown
• Seppreana Brown

• Mental Health Counselor in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.