Provider Demographics
NPI:1881463453
Name:BRUNDRETT, SEAN (LCSW, LAC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BRUNDRETT
Suffix:
Gender:M
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 W CAITHNESS PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3736
Mailing Address - Country:US
Mailing Address - Phone:310-488-6969
Mailing Address - Fax:
Practice Address - Street 1:2607 W CAITHNESS PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3736
Practice Address - Country:US
Practice Address - Phone:310-488-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002445101YA0400X
COCSW.099308341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)