Provider Demographics
NPI:1467122143
Name:MERRIWEATHER, BRITTANY (LCSW,CADC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MERRIWEATHER
Suffix:
Gender:F
Credentials:LCSW,CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 E 158TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1803
Mailing Address - Country:US
Mailing Address - Phone:773-469-1297
Mailing Address - Fax:
Practice Address - Street 1:1214 E 158TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1803
Practice Address - Country:US
Practice Address - Phone:312-520-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0228691041C0700X
IL31411101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)