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NPI Code Detail

MEDICARE: BRITTINAE SAMUEL

MEDICARE: BRITTINAE SAMUEL
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
1101YM0800XMental Health CounselorGA

General Provider Information

NPI Number : 1154270056
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTINAE SAMUEL
Provider Business Mailing Address
First Line : 906 DAWN CT SE
Second Line :
City : CONYERS
State : GA
Zip : 30094-2712
Country : US
Telephone Number : 347-988-7879
Fax Number :
Provider Business Practice Location Address
First Line : 2751 BUFORD HWY NE STE 700
Second Line :
City : ATLANTA
State : GA
Zip : 30324-5510
Country : US
Telephone Number : 347-988-7879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ BRITTINAE SAMUEL ” Practice Location

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