Provider Demographics
NPI:1578947537
Name:BRITO, KEITY (MHP, MSW)
Entity Type:Individual
Prefix:
First Name:KEITY
Middle Name:
Last Name:BRITO
Suffix:
Gender:F
Credentials:MHP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 W 44TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-8401
Mailing Address - Country:US
Mailing Address - Phone:786-548-9915
Mailing Address - Fax:
Practice Address - Street 1:4950 BROADWAY DR APT 1434
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7098
Practice Address - Country:US
Practice Address - Phone:786-548-9915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60583971101YM0800X
FLSW216011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health