Provider Demographics
NPI:1528558764
Name:MENDENHALL, BRITTANY (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MENDENHALL
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ALKYRE RUN STE 250
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6076
Mailing Address - Country:US
Mailing Address - Phone:614-705-2585
Mailing Address - Fax:
Practice Address - Street 1:450 ALKYRE RUN STE 250
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6076
Practice Address - Country:US
Practice Address - Phone:614-705-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2002274-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid