Provider Demographics
NPI:1851701577
Name:CRUICKSHANK, BRITTANY LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:LEE
Last Name:CRUICKSHANK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PINE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12567-5545
Mailing Address - Country:US
Mailing Address - Phone:518-398-7181
Mailing Address - Fax:
Practice Address - Street 1:2829 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-5545
Practice Address - Country:US
Practice Address - Phone:845-398-7181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089418104100000X
1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical