Provider Demographics
NPI:1265258628
Name:FROST, BRITTANY (LPC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:BOOTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 N MATTIS AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-7900
Mailing Address - Country:US
Mailing Address - Phone:224-232-8057
Mailing Address - Fax:217-888-2744
Practice Address - Street 1:313 N MATTIS AVE STE 116
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-7900
Practice Address - Country:US
Practice Address - Phone:224-232-8057
Practice Address - Fax:217-888-2744
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional