Provider Demographics
NPI:1205562550
Name:HASSIS, BRITTANY MARIE (LPC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:HASSIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-4356
Mailing Address - Country:US
Mailing Address - Phone:208-409-5504
Mailing Address - Fax:
Practice Address - Street 1:600 E RIVERPARK LN STE 125
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-6661
Practice Address - Country:US
Practice Address - Phone:208-409-5504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8988101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional