Provider Demographics
NPI:1790136273
Name:DEVINE, BRITTANY CORONADO (MS, LAPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:CORONADO
Last Name:DEVINE
Suffix:
Gender:F
Credentials:MS, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 GROVE PARK DR
Mailing Address - Street 2:APT. 1303
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-1594
Mailing Address - Country:US
Mailing Address - Phone:404-368-3159
Mailing Address - Fax:
Practice Address - Street 1:1448 GROVE PARK DR
Practice Address - Street 2:APT. 1303
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-1594
Practice Address - Country:US
Practice Address - Phone:404-368-3159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health