Provider Demographics
NPI:1649338906
Name:BRITELL, ETHEL C (MSW)
Entity type:Individual
Prefix:MRS
First Name:ETHEL
Middle Name:C
Last Name:BRITELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 DEPOT ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-499-4090
Mailing Address - Fax:413-499-1844
Practice Address - Street 1:34 DEPOT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-499-4090
Practice Address - Fax:413-499-1844
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1016218104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA667870OtherTUFTS
MACOW40032Medicare ID - Type Unspecified