Provider Demographics
NPI:1316736820
Name:PHELAN, BRITTNEY MICHELE
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:MICHELE
Last Name:PHELAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9854 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3606
Mailing Address - Country:US
Mailing Address - Phone:561-699-0579
Mailing Address - Fax:
Practice Address - Street 1:12008 S SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6395
Practice Address - Country:US
Practice Address - Phone:561-699-0579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical