Provider Demographics
NPI:1366019374
Name:DACUS, BRITTANY KRISTEN (CAS)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KRISTEN
Last Name:DACUS
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:DACUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAS
Mailing Address - Street 1:411 S CASCADE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3811
Mailing Address - Country:US
Mailing Address - Phone:719-419-7959
Mailing Address - Fax:
Practice Address - Street 1:411 S CASCADE AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3811
Practice Address - Country:US
Practice Address - Phone:719-419-7959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC0021197101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty