Active NPI
Alyssa Jene' Brown, LPC
- Professional Counselor
- Fredericktown, MO
National Provider Identifier
1982240305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2017042457
- Practice address
- 151 South Main Street, Suite B
Fredericktown, MO 63645-6364 - Phone
- (573) 561-4357
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2017042457 | MO | Primary |
Addresses
Primary practice location
151 South Main Street, Suite B
Fredericktown, MO 63645-6364
Mailing address
151 South Main Street
Suite B
Fredericktown, MO 63645-7707
Phone (573) 222-0096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017042457 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Mental Health | Current | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Fredericktown, MO
- NPI 1215577945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1982240305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 SOUTH MAIN STREET",
"address_2": "SUITE B",
"city": "FREDERICKTOWN",
"state": "MO",
"postal_code": "636457707",
"telephone_number": "573-222-0096",
"fax_number": "573-240-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 SOUTH MAIN STREET, SUITE B",
"city": "FREDERICKTOWN",
"state": "MO",
"postal_code": "636456364",
"telephone_number": "573-561-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "ALYSSA",
"middle_name": "JENE'",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2017042457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericktown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.