Basic Information
| Provider Information | |||||||||
| NPI: | 1003048430 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBER-BROWN | ||||||||
| FirstName: | TROY | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | MS, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 CENTRACARE CIR STE 2375 | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563035000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206543630 | ||||||||
| FaxNumber: | 3202295142 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 CENTRACARE CIR STE 2375 | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563035000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206543633 | ||||||||
| FaxNumber: | 3202295177 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 1919 | MN | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.