Healthcare Provider Details

I. General information

NPI: 1508785361
Provider Name (Legal Business Name): JUSTUS ANNE BREWINGTON BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2565 HAIRE RD
SHANNON NC
28386-9431
US

IV. Provider business mailing address

2565 HAIRE RD
SHANNON NC
28386-9431
US

V. Phone/Fax

Practice location:
  • Phone: 910-302-2299
  • Fax:
Mailing address:
  • Phone: 910-302-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1311707
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: