MEDICARE: BRITTANY N PIERSON MA, LCPC

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	180008362	IL

General Provider Information

NPI Number	:	1639429376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY N PIERSON MA, LCPC

Provider Business Mailing Address
First Line	:	4509 N ILLINOIS ST STE 5
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-1524
Country	:	US
Telephone Number	:	618-920-2238
Fax Number	:

Provider Business Practice Location Address
First Line	:	4509 NORTH ILLINOIS STREET STE 5
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-1524
Country	:	US
Telephone Number	:	618-920-2238
Fax Number	:	877-778-3811

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

Provider Enumeration Date	:	09/10/2012
Last Update Date	:	05/17/2021

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