Healthcare Provider Details

I. General information

NPI: 1013250489
Provider Name (Legal Business Name): STEPHANIE FAITH BREWSTER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1079 THORNBERRY DR SUITE D
MADISONVILLE KY
42431-1600
US

IV. Provider business mailing address

PO BOX 1429
MT WASHINGTON KY
40047-1429
US

V. Phone/Fax

Practice location:
  • Phone: 270-874-2560
  • Fax:
Mailing address:
  • Phone: 502-538-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCPCC00223773
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: