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General NPI Number Information
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NPI Number | 1134299613
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Entity Type | Individual
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Provider Name | MATTHEW D BRITTAIN LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 56 WAIANUENUE AVE STE 207
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City | HILO
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State | HI
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Zip | 96720-2474
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Country | US
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Telephone | 808-934-7566
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Fax | 808-934-9442
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Provider Business Mailing Address
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Address Line | PO BOX 1038
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City | KURTISTOWN
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State | HI
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Zip | 96760-1038
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Country | US
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Telephone | 808-934-7566
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Fax | 808-934-9442
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-3048
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4948-C
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License Number State | NV
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