Provider Demographics
NPI:1942587175
Name:BREWER, HEATHER AMANDA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:AMANDA
Last Name:BREWER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SCRANTON CT
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-6228
Mailing Address - Country:US
Mailing Address - Phone:910-689-4243
Mailing Address - Fax:
Practice Address - Street 1:422 MCARTHUR RD STE 201B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-6928
Practice Address - Country:US
Practice Address - Phone:910-323-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional