=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548922768
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRITTANY NEILON COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2021
-----------------------------------------------------
Last Update Date | 10/06/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6116 N CENTRAL EXPY STE 500
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75206-5131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-550-2907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4435 NORTHAVEN RD
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75229-4125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-296-2070
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | BRITTANY NEILON
-----------------------------------------------------
Credential | MS, LPC
-----------------------------------------------------
Telephone | 817-296-2070
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------