Provider Demographics
NPI:1376236307
Name:BRITANY DOUGHTY PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:BRITANY DOUGHTY PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BRITANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGHTY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-293-2263
Mailing Address - Street 1:40315 MICHIGAN AVE # 1163
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2908
Mailing Address - Country:US
Mailing Address - Phone:989-293-2263
Mailing Address - Fax:
Practice Address - Street 1:40315 MICHIGAN AVE # 1163
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2908
Practice Address - Country:US
Practice Address - Phone:989-293-2263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty