Healthcare Provider Details

I. General information

NPI: 1932517851
Provider Name (Legal Business Name): BRITTANY MYCHAL RUSSELL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HEALTH CLINIC CHARLESTON (NHCC) 110 NNPTC CIRCLE, BLDG. 2418
GOOSE CREEK SC
29445
US

IV. Provider business mailing address

NAVAL HEALTH CLINIC CHARLESTON (NHCC) 110 NNPTC CIRCLE, BLDG. 2418
GOOSE CREEK SC
29445
US

V. Phone/Fax

Practice location:
  • Phone: 843-794-6450
  • Fax:
Mailing address:
  • Phone: 843-794-6450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number739
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: