Provider Demographics
NPI:1790829307
Name:BRECHT, MARCIA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:L
Last Name:BRECHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 HAYWOOD FARMS RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8354
Mailing Address - Country:US
Mailing Address - Phone:252-637-3557
Mailing Address - Fax:
Practice Address - Street 1:2901 N HERRITAGE ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1581
Practice Address - Country:US
Practice Address - Phone:252-233-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC002538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11165OtherBLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC6003561Medicaid
NC6003561Medicaid
NC2866581EMedicare PIN