Provider Demographics
NPI:1992104251
Name:WERLEY, BRENT THOMAS (BA)
Entity type:Individual
Prefix:MR
First Name:BRENT
Middle Name:THOMAS
Last Name:WERLEY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CIRCLE OF PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3811
Mailing Address - Country:US
Mailing Address - Phone:610-970-5410
Mailing Address - Fax:610-970-3330
Practice Address - Street 1:301 CIRCLE OF PROGRESS DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3811
Practice Address - Country:US
Practice Address - Phone:610-970-5410
Practice Address - Fax:610-970-3330
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA24245686101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)