Provider Demographics
NPI:1972255933
Name:MCCORKLE, BRITTNEY
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:MCCORKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:GAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4437 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-4451
Mailing Address - Country:US
Mailing Address - Phone:910-754-4449
Mailing Address - Fax:910-754-3495
Practice Address - Street 1:4437 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4451
Practice Address - Country:US
Practice Address - Phone:910-754-4449
Practice Address - Fax:910-754-3495
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)