Provider Demographics
NPI:1760826259
Name:BREWER, ALYSSA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 STERLING ST STE 32
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1268
Mailing Address - Country:US
Mailing Address - Phone:508-414-4250
Mailing Address - Fax:
Practice Address - Street 1:45 STERLING ST STE 32
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1268
Practice Address - Country:US
Practice Address - Phone:508-414-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1568541670OtherBH SOCIAL SERVICE