Provider Demographics
NPI:1841989738
Name:BIEBERLE, BRETT MICHAEL (LMLP)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:MICHAEL
Last Name:BIEBERLE
Suffix:
Gender:M
Credentials:LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E 8TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4748
Mailing Address - Country:US
Mailing Address - Phone:620-680-0673
Mailing Address - Fax:
Practice Address - Street 1:208 E 8TH ST STE D
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4748
Practice Address - Country:US
Practice Address - Phone:620-680-0673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03218103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist