Provider Demographics
NPI:1891067872
Name:BREWER, NATHAN QUINTER (MSW)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:QUINTER
Last Name:BREWER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 AMORY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1051
Mailing Address - Country:US
Mailing Address - Phone:617-450-1308
Mailing Address - Fax:
Practice Address - Street 1:75 AMORY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1051
Practice Address - Country:US
Practice Address - Phone:617-450-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9971941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical