Provider Demographics
NPI:1275127334
Name:JETTON, BRITTNEY (LPC)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:JETTON
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 1:1125 S ELISEO DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2021
Mailing Address - Country:US
Mailing Address - Phone:770-842-9264
Mailing Address - Fax:
Practice Address - Street 1:188 S LOGAN ST APT 206
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1835
Practice Address - Country:US
Practice Address - Phone:770-842-9264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015542101YP2500X
CALPCC16099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional