Healthcare Provider Details

I. General information

NPI: 1053936898
Provider Name (Legal Business Name): BRITTNEY MATLICK MS, LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 HIGH ST
MORGANTOWN WV
26505-5429
US

IV. Provider business mailing address

439 PINEVIEW RD
MASONTOWN WV
26542-9437
US

V. Phone/Fax

Practice location:
  • Phone: 681-285-1133
  • Fax:
Mailing address:
  • Phone: 304-276-2830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: