Healthcare Provider Details

I. General information

NPI: 1700709771
Provider Name (Legal Business Name): BRITTANY SUTHERLAND RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5449 OXBOW BEND DR
RIVERVIEW FL
33578-5065
US

IV. Provider business mailing address

5449 OXBOW BEND DR
RIVERVIEW FL
33578-5065
US

V. Phone/Fax

Practice location:
  • Phone: 813-943-6229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH28601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: