Healthcare Provider Details

I. General information

NPI: 1023359015
Provider Name (Legal Business Name): BRITTANY D ELLIS CIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 DAUPHIN ISLAND PKWY
MOBILE AL
36605-3004
US

IV. Provider business mailing address

6429 LOUIS ELAM ST
VIOLET LA
70092-3331
US

V. Phone/Fax

Practice location:
  • Phone: 251-476-5733
  • Fax:
Mailing address:
  • Phone: 504-320-9489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberPLC6812
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: