Provider Demographics
NPI:1578300240
Name:BREWER, GRAYSEN (LPC-A)
Entity type:Individual
Prefix:
First Name:GRAYSEN
Middle Name:
Last Name:BREWER
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 COTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3501
Mailing Address - Country:US
Mailing Address - Phone:843-933-5556
Mailing Address - Fax:
Practice Address - Street 1:913 BOWMAN RD STE 104
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3235
Practice Address - Country:US
Practice Address - Phone:843-216-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional