Healthcare Provider Details

I. General information

NPI: 1457095366
Provider Name (Legal Business Name): BRITNI CARVER QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 GRANT ST
PORTSMOUTH OH
45662-3663
US

IV. Provider business mailing address

941 MARKET ST
PIKETON OH
45661-9757
US

V. Phone/Fax

Practice location:
  • Phone: 740-901-0416
  • Fax:
Mailing address:
  • Phone: 740-289-2371
  • Fax: 740-289-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number181732
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.186197
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: