Provider Demographics
NPI:1689450298
Name:BREWTON, ALLISON MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:BREWTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 STONERIDGE DR STE A2
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7047
Mailing Address - Country:US
Mailing Address - Phone:210-288-1481
Mailing Address - Fax:
Practice Address - Street 1:822 STONERIDGE DR # A2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7047
Practice Address - Country:US
Practice Address - Phone:210-288-1481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-57320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health