Provider Demographics
NPI:1699824227
Name:HEWETT, KIRK ALAN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:KIRK
Middle Name:ALAN
Last Name:HEWETT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6331 FAIRMOUNT AVE
Mailing Address - Street 2:#361
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3647
Mailing Address - Country:US
Mailing Address - Phone:510-869-2545
Mailing Address - Fax:510-559-5552
Practice Address - Street 1:2127 ASHBY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1884
Practice Address - Country:US
Practice Address - Phone:510-869-2545
Practice Address - Fax:510-559-5552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health