Provider Demographics
NPI:1841482882
Name:BREWINGTON, SHIRESSE MORGAN (MSW, LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:SHIRESSE
Middle Name:MORGAN
Last Name:BREWINGTON
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:MISS
Other - First Name:SHIRESSE
Other - Middle Name:LYNITAH
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW-C
Mailing Address - Street 1:8910 FAIRHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5130
Mailing Address - Country:US
Mailing Address - Phone:301-806-3615
Mailing Address - Fax:301-574-5249
Practice Address - Street 1:9672 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3670
Practice Address - Country:US
Practice Address - Phone:301-806-3615
Practice Address - Fax:301-574-5249
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133681041C0700X
DCLC500782881041C0700X
VA09040063411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0151211 00Medicaid