Provider Demographics
NPI:1659098275
Name:BLEVINS, BRITTNI MCNEILL (LPA)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:MCNEILL
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 BRAMBLE LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5535
Mailing Address - Country:US
Mailing Address - Phone:817-657-4650
Mailing Address - Fax:
Practice Address - Street 1:777 N WALNUT CREEK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3221
Practice Address - Country:US
Practice Address - Phone:817-657-4650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33279103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty