MEDICARE: MS. CHARRON RENEE BRASHER LPC

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	101YP2500X	Professional Counselor	PC016918	PA
2	101YP2500X	Professional Counselor	63628	TX

General Provider Information

NPI Number	:	1497981005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARRON RENEE BRASHER LPC

Provider Business Mailing Address
First Line	:	PO BOX 746722
Second Line	:	APT 2181
City	:	ATLANTA
State	:	GA
Zip	:	30374-6722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 COTTMAN AVE STE 71
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1007
Country	:	US
Telephone Number	:	215-444-7505
Fax Number	:

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

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	09/15/2025

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