Provider Demographics
NPI:1821462359
Name:KACHALIA, BRITTANY (MS)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:
Last Name:KACHALIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 BEDFORD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-4164
Mailing Address - Country:US
Mailing Address - Phone:252-886-1256
Mailing Address - Fax:
Practice Address - Street 1:7424 BEDFORD RIDGE DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-4164
Practice Address - Country:US
Practice Address - Phone:252-886-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20545101YA0400X
NC11284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)