Healthcare Provider Details

I. General information

NPI: 1023246030
Provider Name (Legal Business Name): LISA BRITT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 HAMPTON POINT DR STE 1
SAINT AUGUSTINE FL
32092-3054
US

IV. Provider business mailing address

1175 WESTWOOD DR
SAINT JOHNS FL
32259-9293
US

V. Phone/Fax

Practice location:
  • Phone: 904-466-1106
  • Fax:
Mailing address:
  • Phone: 904-466-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH7352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: