Provider Demographics
NPI:1043799786
Name:TARRIS, BRITTON ADOLFO (LMSW, LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRITTON
Middle Name:ADOLFO
Last Name:TARRIS
Suffix:
Gender:M
Credentials:LMSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-1315
Mailing Address - Country:US
Mailing Address - Phone:315-717-5787
Mailing Address - Fax:
Practice Address - Street 1:3 ELLINWOOD CT
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1116
Practice Address - Country:US
Practice Address - Phone:315-717-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104360-1104100000X
NY001671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker