Provider Demographics
NPI:1285163766
Name:BASCOMBE, BRITTANY (LGSW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BASCOMBE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11421 LAURELWALK DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3008
Mailing Address - Country:US
Mailing Address - Phone:301-832-4203
Mailing Address - Fax:
Practice Address - Street 1:11421 LAURELWALK DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3008
Practice Address - Country:US
Practice Address - Phone:301-832-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical