Provider Demographics
NPI:1831920909
Name:BRITTANY MATHES WINNICKI PHD PLLC
Entity type:Organization
Organization Name:BRITTANY MATHES WINNICKI PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHES WINNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-671-0839
Mailing Address - Street 1:32 SHERIDAN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4692
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32 SHERIDAN ST APT 2
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4692
Practice Address - Country:US
Practice Address - Phone:617-671-0839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty