Provider Demographics
NPI:1235338773
Name:BREWER, JOY F (MA, AT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:F
Last Name:BREWER
Suffix:
Gender:F
Credentials:MA, AT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SPRING VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:DIVIDE
Mailing Address - State:CO
Mailing Address - Zip Code:80814-8612
Mailing Address - Country:US
Mailing Address - Phone:719-494-3915
Mailing Address - Fax:
Practice Address - Street 1:322 N. TEJON STREET
Practice Address - Street 2:SUITE 223
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:719-494-3915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1094, PROVISIONAL101YP2500X
CO5500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional