Provider Demographics
NPI:1902920879
Name:GARRETT, GRETCHEN HOLMES (LCSW)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:HOLMES
Last Name:GARRETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E ITHICA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-9067
Mailing Address - Country:US
Mailing Address - Phone:956-994-1718
Mailing Address - Fax:956-994-1714
Practice Address - Street 1:217 W NOLANA ST
Practice Address - Street 2:SUITE 14
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2500
Practice Address - Country:US
Practice Address - Phone:956-994-1718
Practice Address - Fax:956-994-1714
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS026271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS02627OtherSTATE LICENSE
TXS02627OtherSTATE LICENSE