Provider Demographics
NPI:1942746862
Name:BURTRAW, BRITTANY (MSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BURTRAW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:CULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 RAINBOW WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-5374
Mailing Address - Country:US
Mailing Address - Phone:812-288-6800
Mailing Address - Fax:
Practice Address - Street 1:215 RAINBOW WAY
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5374
Practice Address - Country:US
Practice Address - Phone:812-288-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2522431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical