Provider Demographics
NPI:1073966263
Name:PARIS, BRITTANY (LSCSW, LCSW, RPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:PARIS
Suffix:
Gender:F
Credentials:LSCSW, LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6939 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-3125
Mailing Address - Country:US
Mailing Address - Phone:816-508-9188
Mailing Address - Fax:
Practice Address - Street 1:6939 KINGSTON CT
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-3125
Practice Address - Country:US
Practice Address - Phone:816-508-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KS49381041C0700X
FL160681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201137330BMedicaid
FL106125300Medicaid