Provider Demographics
NPI:1598915282
Name:SQUYRES, BRIAN STEVEN (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:STEVEN
Last Name:SQUYRES
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 GOVERNMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1613
Mailing Address - Country:US
Mailing Address - Phone:251-478-5906
Mailing Address - Fax:251-478-2237
Practice Address - Street 1:2577 GOVERNMENT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1613
Practice Address - Country:US
Practice Address - Phone:251-478-5906
Practice Address - Fax:251-478-2237
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040058421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical