Provider Demographics
NPI:1558611186
Name:ANTUNES, BRITTANI PASCAL (MC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:PASCAL
Last Name:ANTUNES
Suffix:
Gender:F
Credentials:MC, LPC, NCC
Other - Prefix:
Other - First Name:BRITTANI
Other - Middle Name:
Other - Last Name:PASCAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5023 S ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7732
Mailing Address - Country:US
Mailing Address - Phone:240-801-5251
Mailing Address - Fax:
Practice Address - Street 1:4802 E RAY RD STE 23-646
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6405
Practice Address - Country:US
Practice Address - Phone:240-801-5251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-13884101YM0800X
AZLPC-16204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health