Provider Demographics
NPI:1033642426
Name:MAFFETT, BRETT ALLEN (MS, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:ALLEN
Last Name:MAFFETT
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 NE BAKER ST
Mailing Address - Street 2:P.O. BOX 1329
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4932
Mailing Address - Country:US
Mailing Address - Phone:503-434-9797
Mailing Address - Fax:
Practice Address - Street 1:1004 NE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4932
Practice Address - Country:US
Practice Address - Phone:503-434-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health