Healthcare Provider Details

I. General information

NPI: 1326612920
Provider Name (Legal Business Name): COURTNEY BREWER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 MAIN ST
VILONIA AR
72173-8072
US

IV. Provider business mailing address

1600 ALDERSGATE RD STE 200
LITTLE ROCK AR
72205-6676
US

V. Phone/Fax

Practice location:
  • Phone: 501-772-9278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9654-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: