Provider Demographics
NPI:1346626447
Name:CURTIS, BRITTANY QYNN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:QYNN
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:QYNN
Other - Last Name:ROCKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LPC
Mailing Address - Street 1:PO BOX 50932
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-0016
Mailing Address - Country:US
Mailing Address - Phone:843-331-5350
Mailing Address - Fax:
Practice Address - Street 1:1500 HIGHWAY 17 N STE 201I
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-6078
Practice Address - Country:US
Practice Address - Phone:843-331-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6663101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1869Medicaid