MEDICARE: AMANDA ANN BRITTON 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	101YP2500X	Professional Counselor	0701005808	VA

General Provider Information

NPI Number	:	1467864702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ANN BRITTON LPC

Provider Business Mailing Address
First Line	:	913 RATON CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6640
Country	:	US
Telephone Number	:	757-285-1254
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 THURSTON AVE
Second Line	:	SUITE 209
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-3302
Country	:	US
Telephone Number	:	757-965-7450
Fax Number	:

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

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	05/21/2014

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