MEDICARE: MRS. BRITTANY EDIE 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	101YP2500X	Professional Counselor	PC013300	PA
2	101YP2500X	Professional Counselor	LC4791	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LC4791	OTHER	MD	STATE LICENSE
2	PC013300	OTHER	PA	STATE LICENSURE

General Provider Information

NPI Number	:	1871898551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITTANY EDIE LCPC

Provider Business Mailing Address
First Line	:	397 SAINT BARTHOLOMEW RD
Second Line	:
City	:	HANOVER
State	:	PA
Zip	:	17331-9725
Country	:	US
Telephone Number	:	443-988-0338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 BALTIMORE BLVD STE C
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-7144
Country	:	US
Telephone Number	:	410-861-0036
Fax Number	:

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

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/05/2024

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