Provider Demographics
NPI:1366853335
Name:NANCY A BRIGHTON, LCSW
Entity Type:Organization
Organization Name:NANCY A BRIGHTON, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:386-236-9114
Mailing Address - Street 1:112 ORANGE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4338
Mailing Address - Country:US
Mailing Address - Phone:386-236-9114
Mailing Address - Fax:
Practice Address - Street 1:112 ORANGE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4338
Practice Address - Country:US
Practice Address - Phone:386-236-9114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 28291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty