Healthcare Provider Details

I. General information

NPI: 1013317155
Provider Name (Legal Business Name): TERESA BRASHER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 STATE ROUTE VV
KENNETT MO
63857-3822
US

IV. Provider business mailing address

935 STATE ROUTE VV
KENNETT MO
63857-3822
US

V. Phone/Fax

Practice location:
  • Phone: 573-888-5925
  • Fax:
Mailing address:
  • Phone: 573-888-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2016041689
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: