Healthcare Provider Details

I. General information

NPI: 1124680350
Provider Name (Legal Business Name): BRITNEE S BERRETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 WASHINGTON ST
WATERTOWN NY
13601-4084
US

IV. Provider business mailing address

531 WASHINGTON ST
WATERTOWN NY
13601-4084
US

V. Phone/Fax

Practice location:
  • Phone: 315-782-7445
  • Fax: 315-779-1184
Mailing address:
  • Phone: 315-782-4483
  • Fax: 315-785-9210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107056
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: