Provider Demographics
NPI:1760813166
Name:LAFFITTE, BRITTANY LEIGH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:LEIGH
Last Name:LAFFITTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:LEIGH
Other - Last Name:MCCLINTOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6436 FORWARD PASS TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2006
Mailing Address - Country:US
Mailing Address - Phone:850-830-3886
Mailing Address - Fax:850-942-2003
Practice Address - Street 1:109 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6152
Practice Address - Country:US
Practice Address - Phone:850-830-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2019-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLSW134421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL640777Medicaid