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NPI 1568719508

NPI 1568719508 : BRITTANY HERBERT LCSW : NORTH BALDWIN, NY

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General NPI Number Information
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    NPI Number           |    1568719508
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    Entity Type          |    Individual 
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    Provider Name        |    BRITTANY HERBERT LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/09/2012
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    Last Update Date     |    06/09/2022
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Provider Practice Location Address
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    Address Line         |    637 DE MOTT AVE 
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    City                 |    NORTH BALDWIN
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    State                |    NY
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    Zip                  |    11510-1324
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    Country              |    US
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    Telephone            |    347-645-0904
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    637 DE MOTT AVE 
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    City                 |    NORTH BALDWIN
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    State                |    NY
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    Zip                  |    11510-1324
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    Country              |    US
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    Telephone            |    347-645-0904
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    Fax                  |    
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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        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    086513
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    License Number State |    NY
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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       |    086513
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    License Number State |    NY
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