Healthcare Provider Details

I. General information

NPI: 1043998446
Provider Name (Legal Business Name): JAMES EVAN BREWER LPCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 SCOTTSVILLE RD
BOWLING GREEN KY
42104-3244
US

IV. Provider business mailing address

351 PASCOE BLVD STE 102
BOWLING GREEN KY
42104-6302
US

V. Phone/Fax

Practice location:
  • Phone: 740-417-6774
  • Fax:
Mailing address:
  • Phone: 740-417-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: