Provider Demographics
NPI:1497899058
Name:FITZER, BRETT R (MACPC, PCC)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:R
Last Name:FITZER
Suffix:
Gender:M
Credentials:MACPC, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DORCHESTER SQ N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7304
Mailing Address - Country:US
Mailing Address - Phone:614-776-5311
Mailing Address - Fax:
Practice Address - Street 1:100 DORCHESTER SQ N
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7304
Practice Address - Country:US
Practice Address - Phone:614-776-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health