Healthcare Provider Details
I. General information
NPI: 1255775573
Provider Name (Legal Business Name): CATHERINE ANN BREWER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/18/2013
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2091 PROFESSIONAL DR
FLINT MI
48532-3657
US
IV. Provider business mailing address
11365 COLONIAL WOODS DR
CLIO MI
48420-1503
US
V. Phone/Fax
- Phone: 810-732-1652
- Fax: 810-732-1735
- Phone: 810-368-4052
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 6401013208 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401013208 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: