Individual provider Active NPI

Richard J Brewer, MFT

  • Marriage & Family Therapist
  • Philadelphia, PA
National Provider Identifier
1912092545
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MF000617 Issued in PA
Practice address
1315 Walnut St
#1003
Philadelphia, PA 19107-4719
Phone
(215) 764-5728
Fax
(215) 875-9975
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC35609 CA
Marriage & Family Therapist 106H00000X MF000617 PA Primary

Addresses

Primary practice location

1315 Walnut St
#1003
Philadelphia, PA 19107-4719

Mailing address

1315 Walnut St
#1003
Philadelphia, PA 19107-4719
Phone (215) 764-5728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC35609CAMDMarriage & Family Therapist
MF000617PAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1912092545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 WALNUT ST",
            "address_2": "#1003",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074719",
            "telephone_number": "215-764-5728",
            "fax_number": "215-875-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 WALNUT ST",
            "address_2": "#1003",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074719",
            "telephone_number": "215-764-5728",
            "fax_number": "215-875-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC35609",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.