Provider Demographics
NPI:1346918299
Name:BREWER, LINDSEY (BCBA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BREWER
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 WYNTER FROST WALK
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:GA
Mailing Address - Zip Code:30620-4688
Mailing Address - Country:US
Mailing Address - Phone:770-510-9072
Mailing Address - Fax:
Practice Address - Street 1:4319 S LEE ST
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5747
Practice Address - Country:US
Practice Address - Phone:678-288-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-25-79648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst