MEDICARE: BRITTANY OGDEN MSW, LCSW, CSAYC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34011329A	IN

General Provider Information

NPI Number	:	1043982119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY OGDEN MSW, LCSW, CSAYC

Provider Business Mailing Address
First Line	:	PO BOX 809
Second Line	:
City	:	GOSHEN
State	:	IN
Zip	:	46527-0809
Country	:	US
Telephone Number	:	574-533-1234
Fax Number	:	574-537-2652

Provider Business Practice Location Address
First Line	:	1313 W WASHINGTON CENTER RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-4142
Country	:	US
Telephone Number	:	260-424-4908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	03/20/2025

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