Provider Demographics
NPI:1649784638
Name:BREWER COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:BREWER COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:GRAF
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:414-322-9555
Mailing Address - Street 1:W49N669 CEDAR RESERVE CIR
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-3501
Mailing Address - Country:US
Mailing Address - Phone:414-322-9555
Mailing Address - Fax:
Practice Address - Street 1:14135 N CEDARBURG RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-1416
Practice Address - Country:US
Practice Address - Phone:262-377-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2646103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty