DR. SUPAVAN K BROWN (PH.D.) – Counseling Psychologist, NPI 1124391388

DR. SUPAVAN K BROWN (PH.D.) is a healthcare provider. based in Lees summit, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 2011038966 (MO). The NPI Number for DR. SUPAVAN K BROWN (PH.D.) is 1124391388

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUPAVAN K BROWN (PH.D.)
NPI
1124391388
Phone
(816) 404-6189
Address
300 SE 2ND ST
Enumeration Date
20 February 2012
Last Update Date
20 February 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8164045709
Graduation Year
2009 (17 years ago)
PAC ID
4789845967
Group Practice PAC ID
7315841418
Professional Enrollment ID
I20120416000287
Address ID
MO641082026KA300XXTERX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

Provider Addresses for DR. SUPAVAN K BROWN (PH.D.)

  • 300 SE 2ND ST

    SUITE 100

    LEES SUMMIT, MO 640632759

    Phone: (816) 404-6189

    Fax: (816) 525-2251

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120416000287IClinical PsychologistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96158Treatment of behavior impacting health, initial 30 minutes6611$0
View full utilization report →

Insurance plans in this area (ZIP 64063)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315841418View full group profile
NameSpecialtyState
-NM
Nurse PractitionerMO
-IL
-MO
-MO
Certified Registered Nurse Anesthetist (Crna)MO
-MO
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YMO
Nurse PractitionerMO

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Frequently asked questions

How do I look up DR. SUPAVAN K BROWN (PH.D.) by NPI?
Use NPI 1124391388 when you need to reference DR. SUPAVAN K BROWN (PH.D.) in forms, claims, or directories.
Is DR. SUPAVAN K BROWN (PH.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. SUPAVAN K BROWN (PH.D.)'s specialty in plain language?
Clinically, the directory lists DR. SUPAVAN K BROWN (PH.D.) with Counseling Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. SUPAVAN K BROWN (PH.D.) practice in Missouri?
You will see Lees Summit, Missouri on file for DR. SUPAVAN K BROWN (PH.D.) alongside any extra practice locations.
Is DR. SUPAVAN K BROWN (PH.D.) a real provider?
This page reflects official NPPES data for NPI 1124391388. Always confirm identity and privileges with the practice and licensing boards.

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