Healthcare Provider Details

I. General information

NPI: 1932751740
Provider Name (Legal Business Name): KPB WEWER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W POMFRET ST
CARLISLE PA
17013-3217
US

IV. Provider business mailing address

47 W POMFRET ST
CARLISLE PA
17013-3217
US

V. Phone/Fax

Practice location:
  • Phone: 717-258-0214
  • Fax: 717-258-3158
Mailing address:
  • Phone: 717-258-0214
  • Fax: 717-258-3158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTIN P BRENIZE-WEWER
Title or Position: OWNER
Credential: MS, LMFT
Phone: 717-258-0214