Provider Demographics
NPI:1417765728
Name:BRETT, ANDREW LIVINGSTON (MA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LIVINGSTON
Last Name:BRETT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 3RD AVE N STE 300
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3245
Mailing Address - Country:US
Mailing Address - Phone:727-214-0428
Mailing Address - Fax:
Practice Address - Street 1:447 3RD AVE N STE 300
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3245
Practice Address - Country:US
Practice Address - Phone:727-214-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health