Provider Demographics
NPI:1619756103
Name:TATUM, BRITTNEY T (LPC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:T
Last Name:TATUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 BLAIR RD, SUITE 100
Mailing Address - Street 2:PMB 220397
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4101
Mailing Address - Country:US
Mailing Address - Phone:469-984-9980
Mailing Address - Fax:469-519-5317
Practice Address - Street 1:3704 POTEET DRIVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:469-984-9980
Practice Address - Fax:469-519-5317
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84807101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health