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General NPI Number Information
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NPI Number | 1790087807
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Entity Type | Individual
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Provider Name | NICOLE MARIE BREWER CPC, LCADC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 08/24/2020
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Provider Practice Location Address
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Address Line | 2470 SAINT ROSE PKWY STE 201
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City | HENDERSON
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State | NV
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Zip | 89074-7774
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Country | US
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Telephone | 702-496-6562
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Fax | 702-993-8283
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Provider Business Mailing Address
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Address Line | 2470 SAINT ROSE PKWY STE 201
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City | HENDERSON
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State | NV
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Zip | 89074-7774
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Country | US
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Telephone | 702-496-6562
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Fax | 702-993-8283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 323-LC
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CP0069
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License Number State | NV
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