MEDICARE: DR. CAROLE STOKES-BREWER PHD, LISW, LPCC, LIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I3014	OH

General Provider Information

NPI Number	:	1417003799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLE STOKES-BREWER PHD, LISW, LPCC, LIC

Provider Business Mailing Address
First Line	:	4200 PRIMARY COLORS
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-7931
Country	:	US
Telephone Number	:	513-889-0084
Fax Number	:	513-889-0084

Provider Business Practice Location Address
First Line	:	6580 SOSNA DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-2222
Country	:	US
Telephone Number	:	513-889-0084
Fax Number	:	513-889-0084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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