1326005836 NPI number — TIMAREE CATHERINE BROWN PMHNP-BC

Table of content: TIMAREE CATHERINE BROWN PMHNP-BC (NPI 1326005836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326005836 NPI number — TIMAREE CATHERINE BROWN PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
TIMAREE
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326005836
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
391 VARNUM AVE
Provider Second Line Business Mailing Address:
LOWELL TREATMENT CENTER
Provider Business Mailing Address City Name:
LOWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01854-2119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-703-2212
Provider Business Mailing Address Fax Number:
978-703-2490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
391 VARNUM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01854-2119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-703-2212
Provider Business Practice Location Address Fax Number:
978-703-2490
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  6439 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: F401997 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: RN148123 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2015003386 . This is a "MA NP CERTIFICATION NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1898906 . This is a "MEDICAID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1245594894 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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