Provider Demographics
NPI:1801325188
Name:BRUETT, THOMAS (LMFT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:BRUETT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:TOM
Other - Middle Name:
Other - Last Name:BRUETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2855 N SPEER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4240
Mailing Address - Country:US
Mailing Address - Phone:415-508-6450
Mailing Address - Fax:
Practice Address - Street 1:2855 N SPEER BLVD STE D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4240
Practice Address - Country:US
Practice Address - Phone:415-508-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001922106H00000X
CA99956106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist