Provider Demographics
NPI:1598974545
Name:NEEDHAM, BRETT SEELY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:SEELY
Last Name:NEEDHAM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 MANILA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1311
Mailing Address - Country:US
Mailing Address - Phone:713-203-4803
Mailing Address - Fax:
Practice Address - Street 1:818 RINGOLD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6368
Practice Address - Country:US
Practice Address - Phone:713-203-4803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX396751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L5944Medicare PIN