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General NPI Number Information
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NPI Number | 1366845349
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Entity Type | Organization
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Legal Business Name | LISA BRITT, MS, EDS, LMHC, PA
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 157 HAMPTON POINT DR STE 1
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3054
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Country | US
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Telephone | 904-466-1106
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 600353
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City | JACKSONVILLE
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State | FL
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Zip | 32260-0353
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Country | US
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Telephone | 904-466-1106
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | LISA BRITT
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Credential |
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Telephone | 904-466-1106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH7352
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License Number State | FL
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