Provider Demographics
NPI:1235334855
Name:BREMUS, HEATHER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:BREMUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 DULUTH PARK LN
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3242
Mailing Address - Country:US
Mailing Address - Phone:404-210-7100
Mailing Address - Fax:678-957-0939
Practice Address - Street 1:3500 DULUTH PARK LN
Practice Address - Street 2:SUITE 410
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3242
Practice Address - Country:US
Practice Address - Phone:404-210-7100
Practice Address - Fax:678-957-0939
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0032881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical