Provider Demographics
NPI:1558078378
Name:ATWATER, BRITTANY MICHELLE (MS, LCMHC-A, CRC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:ATWATER
Suffix:
Gender:F
Credentials:MS, LCMHC-A, CRC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MICHELLE
Other - Last Name:ATWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1834
Mailing Address - Country:US
Mailing Address - Phone:704-237-4240
Mailing Address - Fax:704-547-3150
Practice Address - Street 1:4224 MEREDITH WOODS LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-6969
Practice Address - Country:US
Practice Address - Phone:828-449-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional