Provider Demographics
NPI:1689910200
Name:D'AOUST, BRETT MICHAEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:MICHAEL
Last Name:D'AOUST
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 1:1612 OAK HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2975
Mailing Address - Country:US
Mailing Address - Phone:352-552-5582
Mailing Address - Fax:
Practice Address - Street 1:1612 OAK HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2975
Practice Address - Country:US
Practice Address - Phone:352-552-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2333101Y00000X
FLSW159101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor