Provider Demographics
NPI:1902663057
Name:BRENEGAR, STEWART (LPC)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:
Last Name:BRENEGAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VINTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3120
Mailing Address - Country:US
Mailing Address - Phone:828-279-4460
Mailing Address - Fax:
Practice Address - Street 1:1046 OLD BUNCOMBE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-6250
Practice Address - Country:US
Practice Address - Phone:864-209-1820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019047946101Y00000X
SC9397101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor