Provider Demographics
NPI:1306841689
Name:BREWER, DONALD P (EDD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:P
Last Name:BREWER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RAWSON WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-1131
Mailing Address - Country:US
Mailing Address - Phone:513-260-1778
Mailing Address - Fax:513-961-8646
Practice Address - Street 1:3445 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-1760
Practice Address - Country:US
Practice Address - Phone:513-260-1778
Practice Address - Fax:513-961-8646
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH82782101YA0400X
OH00000542101YM0800X
OH5654103T00000X
OHI00028491041C0700X
KY07231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000033427OtherANTHEM
OHB6269OtherAPS HEALTHCARE
56863638OtherUBH