Kelly Brewer, LSW

Key facts

NPI

1750107173

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

SW136603 (PA)

Practice address

3347 Corporate Parkway
Center Valley, PA 18034

Phone

(267) 217-2068

NPI assigned

Dec 2, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2024.

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1750107173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 WASHINGTON ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180424341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3347 CORPORATE PARKWAY",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "18034",
            "telephone_number": "267-217-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "KELLY",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW136603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Center Valley, PA · Clinical Social Worker in Pennsylvania