MEDICARE: JOHN ANDREW BRITTON LADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	001199	CT

General Provider Information

NPI Number	:	1356799571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANDREW BRITTON LADC

Provider Business Mailing Address
First Line	:	139 ORANGE ST
Second Line	:	FOURTH FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3140
Country	:	US
Telephone Number	:	203-937-2309
Fax Number	:

Provider Business Practice Location Address
First Line	:	139 ORANGE ST
Second Line	:	FOURTH FLOOR
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3140
Country	:	US
Telephone Number	:	203-937-2309
Fax Number	:

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

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	05/27/2016

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