Provider Demographics
NPI:1922166420
Name:BRITT, KELLY JOYCE (PSYD, LCP, CSOTP)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JOYCE
Last Name:BRITT
Suffix:
Gender:F
Credentials:PSYD, LCP, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10109 KRAUSE RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838
Mailing Address - Country:US
Mailing Address - Phone:804-217-7404
Mailing Address - Fax:
Practice Address - Street 1:10109 KRAUSE RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838
Practice Address - Country:US
Practice Address - Phone:804-217-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical