Healthcare Provider Details

I. General information

NPI: 1770265589
Provider Name (Legal Business Name): BRITTNEY BOURNE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SOUTHWIND PL STE 1B
MANHATTAN KS
66503-3152
US

IV. Provider business mailing address

227 SOUTHWIND PL STE 1B
MANHATTAN KS
66503-3152
US

V. Phone/Fax

Practice location:
  • Phone: 785-369-1375
  • Fax: 785-706-5012
Mailing address:
  • Phone: 785-367-3538
  • Fax: 785-706-5012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number03860
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72825
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: