Provider Demographics
NPI:1013627868
Name:BRETT, ELIZABETH T (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:BRETT
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 1:136 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-8818
Mailing Address - Country:US
Mailing Address - Phone:814-404-3577
Mailing Address - Fax:
Practice Address - Street 1:3208 BENNER PIKE STE 9
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-8465
Practice Address - Country:US
Practice Address - Phone:814-342-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0228431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical