Healthcare Provider Details

I. General information

NPI: 1720991359
Provider Name (Legal Business Name): WENDE WHITE BREWER PHD, LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 WOODBINE RD
PACE FL
32571-8706
US

IV. Provider business mailing address

1183 HIGHWAY 162
BENTON LA
71006-4130
US

V. Phone/Fax

Practice location:
  • Phone: 850-328-5506
  • Fax:
Mailing address:
  • Phone: 850-328-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC9438
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH7554
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: