Provider Demographics
NPI:1477077881
Name:FRETT, KIEL (LCMHC, LCAS)
Entity Type:Individual
Prefix:
First Name:KIEL
Middle Name:
Last Name:FRETT
Suffix:
Gender:M
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:KIEL
Other - Middle Name:
Other - Last Name:FRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3326 DURHAM CHAPEL HILL BLVD STE 130B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6244
Mailing Address - Country:US
Mailing Address - Phone:919-389-5591
Mailing Address - Fax:
Practice Address - Street 1:943 W ANDREWS AVE STE H
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2562
Practice Address - Country:US
Practice Address - Phone:252-433-0061
Practice Address - Fax:252-433-0065
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23643101YA0400X
NCA12994101YP2500X
NC12994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)