Provider Demographics
NPI:1003565359
Name:DAVIS, BRITTANY MARIE (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7324
Mailing Address - Country:US
Mailing Address - Phone:636-541-6515
Mailing Address - Fax:
Practice Address - Street 1:1025 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7324
Practice Address - Country:US
Practice Address - Phone:636-541-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH21297OtherLICENSED MENTAL HEALTH COUNSELOR