Healthcare Provider Details

I. General information

NPI: 1124595152
Provider Name (Legal Business Name): BRITTANY MARIE VITTOR LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM AL
35209-1317
US

IV. Provider business mailing address

101 SOTHEL CT
GREER SC
29651-2033
US

V. Phone/Fax

Practice location:
  • Phone: 334-717-5144
  • Fax: 929-596-7897
Mailing address:
  • Phone: 334-717-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6671732
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09931154
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5979C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: