MEDICARE: BRITNYE SINCERE VANN

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

General Provider Information

NPI Number	:	1346939154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITNYE SINCERE VANN

Provider Business Mailing Address
First Line	:	1414 MAIN ST
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-4375
Country	:	US
Telephone Number	:	708-681-0073
Fax Number	:

Provider Business Practice Location Address
First Line	:	6454 N SACRAMENTO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4375
Country	:	US
Telephone Number	:	773-672-9495
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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