Provider Demographics
NPI:1578338083
Name:DANES, BRITTANY JEAN (SAC-IT)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:JEAN
Last Name:DANES
Suffix:
Gender:F
Credentials:SAC-IT
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:JEAN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-0347
Mailing Address - Country:US
Mailing Address - Phone:920-894-1374
Mailing Address - Fax:920-894-1373
Practice Address - Street 1:13111 LAX CHAPEL RD
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-3954
Practice Address - Country:US
Practice Address - Phone:920-286-4488
Practice Address - Fax:920-894-1373
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20364130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)