Individual provider Active NPI

Kelsey Brewer, MS, LPC, CCTP

  • Mental Health Counselor
  • Lubbock, TX
National Provider Identifier
1164004909
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
75205 Issued in TX
Practice address
2505 79TH St Ste a
Lubbock, TX 79423-2211
Phone
(806) 781-7378
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 75205 TX Primary

Addresses

Primary practice location

2505 79TH St Ste a
Lubbock, TX 79423-2211

Mailing address

6901 90TH St
Lubbock, TX 79424-8901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 26, 2024 through Jul 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
75205TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brewer Counseling, LLC CurrentSince Apr 25, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1164004909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 90TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 79TH ST STE A",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794232211",
            "telephone_number": "806-781-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "KELSEY",
        "credential": "MS, LPC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "75205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.