Provider Demographics
NPI:1710247135
Name:DOWNEY, LAURIE BREWER (PHD,LPCSL,SOTP-S,SAP)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:BREWER
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:PHD,LPCSL,SOTP-S,SAP
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD,LPC,LSOTP,SAP
Mailing Address - Street 1:8132 TUMBLEWEED TRL
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-3519
Mailing Address - Country:US
Mailing Address - Phone:682-702-1453
Mailing Address - Fax:
Practice Address - Street 1:2727 MORGAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1817
Practice Address - Country:US
Practice Address - Phone:682-702-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14891101YP1600X
TX12175103TA0400X
TX72379101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX353689804Medicaid
TX353689803Medicaid
TX353689802Medicaid
TX1679931547Medicaid