Provider Demographics
NPI:1053590729
Name:BRETTON, MARJORIE KAY (LMHC CAP)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:KAY
Last Name:BRETTON
Suffix:
Gender:F
Credentials:LMHC CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8895 N MILITARY TRL
Mailing Address - Street 2:SUITE 303-E
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6220
Mailing Address - Country:US
Mailing Address - Phone:561-371-0132
Mailing Address - Fax:561-684-8812
Practice Address - Street 1:8895 N MILITARY TRL
Practice Address - Street 2:SUITE 303-E
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6220
Practice Address - Country:US
Practice Address - Phone:561-371-0132
Practice Address - Fax:561-684-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2123101YA0400X
FL5707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)