Provider Demographics
NPI:1639916059
Name:BRITTINGHAM, DARIUS C (LGPC)
Entity type:Individual
Prefix:
First Name:DARIUS
Middle Name:C
Last Name:BRITTINGHAM
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 SANSBURY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2484
Mailing Address - Country:US
Mailing Address - Phone:215-990-3538
Mailing Address - Fax:
Practice Address - Street 1:1300 MERCANTILE LN STE 208
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5340
Practice Address - Country:US
Practice Address - Phone:301-583-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health