Healthcare Provider Details

I. General information

NPI: 1265052138
Provider Name (Legal Business Name): STEPHANIE BRASHEAR M.A., LPCC-S, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 ANGELL ST
PROVIDENCE RI
02906-3245
US

IV. Provider business mailing address

325 ANGELL ST
PROVIDENCE RI
02906-3245
US

V. Phone/Fax

Practice location:
  • Phone: 803-367-2512
  • Fax:
Mailing address:
  • Phone: 803-367-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2001925
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7427
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: