Individual provider Active NPI

Shae Marie Brewer, LCSW

  • Clinical Social Worker
  • Jonesboro, AR
National Provider Identifier
1295246536
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7704-C Issued in AR
Practice address
1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870
Phone
(870) 933-6886
Fax
(870) 933-9395
NPI assigned
Oct 13, 2017
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7704-M AR
Clinical Social Worker 1041C0700X 7704-C AR Primary

Addresses

Primary practice location

1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870

Mailing address

1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other practice location 1

339 Highway 463 N
Trumann, AR 72472-3505
Phone (870) 483-7039

Other names 1

  • Shae Brewer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031000616 AR Practitioner - Clinical Social Worker 1759737521 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7704-MARMDSocial Worker
7704-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Families, Inc of Arkansas CurrentSince Aug 12, 2023 Accepting new patients
Karen Hall, LCSW, PA Social Worker CurrentSince Oct 29, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical PastSince Dec 21, 2025 Accepting new patients
United Methodist Behavioral Health System, Inc Past Accepting new patients
United Methodist Behavioral Health Systems, Inc Past Accepting new patients
TDS Psychiatric Services L.L.C. PastSince Sep 12, 2018 Accepting new patients

Locations

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

1905 Chateau Blvd
Paragould, AR 72450
Phone (870) 236-2265

1905 Chateau Blvd
Ste B
Paragould, AR 72450
Phone (870) 236-2265

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1295246536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Highway 463 N",
            "address_purpose": "LOCATION",
            "city": "Trumann",
            "state": "AR",
            "postal_code": "724723505",
            "country_code": "US",
            "telephone_number": "870-483-7039",
            "fax_number": "870-483-0590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "SHAE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "7704-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7704-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAE",
            "last_name": "BREWER",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.