Provider Demographics
NPI:1306467121
Name:LOLLIS, BRITTNEY (LMSW, LCDC)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:LOLLIS
Suffix:
Gender:F
Credentials:LMSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 LYNDON LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-3704
Mailing Address - Country:US
Mailing Address - Phone:512-278-4936
Mailing Address - Fax:
Practice Address - Street 1:8455 LYNDON LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-3704
Practice Address - Country:US
Practice Address - Phone:512-278-4936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX647831041C0700X
TX13617101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical