Provider Demographics
NPI:1275627721
Name:BRITAIN, MARK S (LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:BRITAIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 50360
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0360
Mailing Address - Country:US
Mailing Address - Phone:806-351-1560
Mailing Address - Fax:806-351-0343
Practice Address - Street 1:1901 MEDIPARK SUITE 222
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-352-5582
Practice Address - Fax:806-352-5596
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10974101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2232LCOtherBLUE CROSS & BLUE SHIELD