Provider Demographics
NPI:1093235640
Name:BREWER COUNSELING, LLC
Entity Type:Organization
Organization Name:BREWER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-880-8622
Mailing Address - Street 1:317 SPARROWHAWK ROAD
Mailing Address - Street 2:
Mailing Address - City:FORDLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65652-8382
Mailing Address - Country:US
Mailing Address - Phone:417-880-8622
Mailing Address - Fax:417-708-8963
Practice Address - Street 1:317 SPARROWHAWK RD
Practice Address - Street 2:
Practice Address - City:FORDLAND
Practice Address - State:MO
Practice Address - Zip Code:65652-8382
Practice Address - Country:US
Practice Address - Phone:417-880-8622
Practice Address - Fax:417-708-8963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000150524101YP2500X
MO2000148997171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty