Provider Demographics
NPI:1124251897
Name:BREWER, LINDA M (LICSW, MLADC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:BREWER
Suffix:
Gender:F
Credentials:LICSW, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX # 712
Mailing Address - Street 2:252 DANIEL WEBSTER HWY. STE #2
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-0712
Mailing Address - Country:US
Mailing Address - Phone:603-393-6292
Mailing Address - Fax:603-279-5008
Practice Address - Street 1:252 DANIEL WEBSTER HWY.
Practice Address - Street 2:STE #2
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-0712
Practice Address - Country:US
Practice Address - Phone:603-393-6292
Practice Address - Fax:603-279-5008
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0508101YA0400X
NH15971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)