Provider Demographics
NPI:1518425594
Name:MCNICKLE, BRITTANY ANN (MPH, CPH)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:MCNICKLE
Suffix:
Gender:F
Credentials:MPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 N PINELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5780
Mailing Address - Country:US
Mailing Address - Phone:727-547-5200
Mailing Address - Fax:727-545-0125
Practice Address - Street 1:1919 N PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5780
Practice Address - Country:US
Practice Address - Phone:727-547-5200
Practice Address - Fax:727-545-0125
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty