Healthcare Provider Details

I. General information

NPI: 1366377152
Provider Name (Legal Business Name): DANASIA BREWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E 5TH ST
LUMBERTON NC
28358-5576
US

IV. Provider business mailing address

210 E 5TH ST
LUMBERTON NC
28358-5576
US

V. Phone/Fax

Practice location:
  • Phone: 910-536-1027
  • Fax: 704-228-7011
Mailing address:
  • Phone: 910-536-1027
  • Fax: 704-228-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPO23856
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: