MEDICARE: MARCIA E BREWER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2000150524	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548266430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA E BREWER LPC

Provider Business Mailing Address
First Line	:	317 SPARROWHAWK RD
Second Line	:
City	:	FORDLAND
State	:	MO
Zip	:	65652-8382
Country	:	US
Telephone Number	:	417-880-8622
Fax Number	:	417-708-8968

Provider Business Practice Location Address
First Line	:	1004 E SKYLINE AVE
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-7809
Country	:	US
Telephone Number	:	417-880-8622
Fax Number	:	417-708-8968

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/21/2022

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Directions to “ MARCIA E BREWER LPC” Practice Location

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