Provider Demographics
NPI:1861530982
Name:BREWINGTON, KATYA (MED, NCC, LPC/MHSP)
Entity type:Individual
Prefix:MS
First Name:KATYA
Middle Name:
Last Name:BREWINGTON
Suffix:
Gender:F
Credentials:MED, NCC, LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 TROUSDALE DR.
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204
Mailing Address - Country:US
Mailing Address - Phone:615-301-8431
Mailing Address - Fax:615-469-0130
Practice Address - Street 1:4623 TROUSDALE DR.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204
Practice Address - Country:US
Practice Address - Phone:615-301-8431
Practice Address - Fax:615-469-0130
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1524333Medicaid