Provider Demographics
NPI:1215260682
Name:BRITTON, DESIRAE (LPC)
Entity type:Individual
Prefix:
First Name:DESIRAE
Middle Name:
Last Name:BRITTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12852 E SHADOW LN
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:ID
Mailing Address - Zip Code:83801-5065
Mailing Address - Country:US
Mailing Address - Phone:208-818-0532
Mailing Address - Fax:
Practice Address - Street 1:1042 W MILL AVE
Practice Address - Street 2:STE 205
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2489
Practice Address - Country:US
Practice Address - Phone:208-446-9733
Practice Address - Fax:208-292-4544
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health