Provider Demographics
NPI:1750714853
Name:BAXTER DAMERON, BRITTNEY (LICSW, LISW)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BAXTER DAMERON
Suffix:
Gender:F
Credentials:LICSW, LISW
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:18330 US HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-5589
Mailing Address - Country:US
Mailing Address - Phone:319-429-2807
Mailing Address - Fax:
Practice Address - Street 1:18330 US HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-5589
Practice Address - Country:US
Practice Address - Phone:712-624-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008219104100000X, 1041C0700X
MN331301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker