Provider Demographics
NPI:1891345880
Name:TYRRELL, BRITTANY (LMSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:TYRRELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 LEGENDARY DR APT 8207
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-4039
Mailing Address - Country:US
Mailing Address - Phone:617-771-5888
Mailing Address - Fax:
Practice Address - Street 1:9501 N CAPITAL OF TEXAS HWY STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7250
Practice Address - Country:US
Practice Address - Phone:512-578-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225972104100000X
TX104684104100000X, 1041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program