MEDICARE: DR. KELLY JOYCE BRITT PSY.D., LCP, CSOTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810003495	VA

General Provider Information

NPI Number	:	1922166420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY JOYCE BRITT PSY.D., LCP, CSOTP

Provider Business Mailing Address
First Line	:	10109 KRAUSE RD.
Second Line	:	SUITE 100
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838
Country	:	US
Telephone Number	:	804-217-7404
Fax Number	:

Provider Business Practice Location Address
First Line	:	10109 KRAUSE RD.
Second Line	:	SUITE 100
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838
Country	:	US
Telephone Number	:	804-217-7404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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