Provider Demographics
NPI:1912578915
Name:BREWER, HEIDI (LMFT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:NAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:414 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2203
Mailing Address - Country:US
Mailing Address - Phone:973-879-1339
Mailing Address - Fax:
Practice Address - Street 1:1363 FLORIDA A1A
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937
Practice Address - Country:US
Practice Address - Phone:321-777-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4088106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist