Provider Demographics
NPI:1699501452
Name:KASS, BRETT
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:KASS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 GREEN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9708
Mailing Address - Country:US
Mailing Address - Phone:319-330-7102
Mailing Address - Fax:
Practice Address - Street 1:5005 BOWLING ST SW STE C
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5070
Practice Address - Country:US
Practice Address - Phone:319-432-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT23125101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)