Provider Demographics
NPI:1306823430
Name:HETRICK, BRETT (LPCS, LMFT, NCC,CART)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:HETRICK
Suffix:
Gender:M
Credentials:LPCS, LMFT, NCC,CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 FAIRVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:KRUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2811
Mailing Address - Country:US
Mailing Address - Phone:940-367-8398
Mailing Address - Fax:
Practice Address - Street 1:207 W HICKORY ST
Practice Address - Street 2:SUITE 213
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4156
Practice Address - Country:US
Practice Address - Phone:940-367-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61305101YP2500X
TX200982106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional