Provider Demographics
NPI:1982820650
Name:BREER, WILLIAM MARTIN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MARTIN
Last Name:BREER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23630 HILLVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-1010
Mailing Address - Country:US
Mailing Address - Phone:909-886-8239
Mailing Address - Fax:909-886-7334
Practice Address - Street 1:22365 BARTON RD
Practice Address - Street 2:SUITE 314
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5015
Practice Address - Country:US
Practice Address - Phone:909-825-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 73301041C0700X
CAM14503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist