| Brown Behavioral Health Services | |
|
623 Moss Ln Bolivar TN 38008-1074 | |
| (901) 864-9563 | |
| Not Available |
| Full Name | Brown Behavioral Health Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 623 Moss Ln, Bolivar, Tennessee |
| Authorized Official Name and Position | Avanti Cross-brown (PMHNP) |
| Authorized Official Contact | 7312289068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brown Behavioral Health Services 623 Moss Ln Bolivar TN 38008-1074 Ph: (901) 864-9563 | Brown Behavioral Health Services 623 Moss Ln Bolivar TN 38008-1074 Ph: (901) 864-9563 |
| NPI Number | 1699416636 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 2668850710 |
|---|---|
| Medicare Enrollment ID | O20220602001208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699416636 | NPI | - | NPPES |
| Provider Name | Avanti Cross-brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144846767 PECOS PAC ID: 6002219607 Enrollment ID: I20210720001879 |
| Provider Name | Kelley Catherine Lewin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851777270 PECOS PAC ID: 4688078231 Enrollment ID: I20210804003056 |
| Provider Name | Jessica Lynn Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376205617 PECOS PAC ID: 1759743743 Enrollment ID: I20230808001034 |
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