Provider Demographics
NPI:1780704973
Name:BRANDT, RHETT KENNEDY (PHD, LMHC, CAP)
Entity type:Individual
Prefix:DR
First Name:RHETT
Middle Name:KENNEDY
Last Name:BRANDT
Suffix:
Gender:M
Credentials:PHD, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 CLEVELAND HEIGHTS BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2243
Mailing Address - Country:US
Mailing Address - Phone:863-701-7202
Mailing Address - Fax:863-701-9262
Practice Address - Street 1:4720 CLEVELAND HEIGHTS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2243
Practice Address - Country:US
Practice Address - Phone:863-701-7202
Practice Address - Fax:863-701-9262
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 2683101YA0400X
FLMH 6787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health