Provider Demographics
NPI:1043556624
Name:MURRAY, BRITTNEY TATTERSALL (LCPC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:TATTERSALL
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:TATTERSALL
Other - Last Name:BRISTOW-MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:414-219-5000
Mailing Address - Fax:414-219-5422
Practice Address - Street 1:1020 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1308
Practice Address - Country:US
Practice Address - Phone:414-219-5000
Practice Address - Fax:414-219-5422
Is Sole Proprietor?:No
Enumeration Date:2012-12-30
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10811101YP2500X
WI6150101YP2500X
IL180.009964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional