MEDICARE: BRITTANY LEIGH PIVIK LPC

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	101YM0800X	Mental Health Counselor	1324	WY
2	171M00000X	Case Manager/Care Coordinator
3	101YP2500X	Professional Counselor	LPC0021546	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063891802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY LEIGH PIVIK LPC

Provider Business Mailing Address
First Line	:	3000 S COLLEGE AVE UNIT 210
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2558
Country	:	US
Telephone Number	:	970-472-1207
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 S COLLEGE AVE UNIT 210
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2558
Country	:	US
Telephone Number	:	970-472-1207
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	03/28/2025

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