Provider Demographics
NPI:1396102430
Name:RHYNOLD, BRITTANI (MHRT-CSP)
Entity type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:RHYNOLD
Suffix:
Gender:F
Credentials:MHRT-CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 STACKPOLE ROAD
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-0000
Mailing Address - Country:US
Mailing Address - Phone:207-667-6890
Mailing Address - Fax:207-667-6457
Practice Address - Street 1:710 STACKPOLE ROAD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-0000
Practice Address - Country:US
Practice Address - Phone:207-667-6890
Practice Address - Fax:207-667-6457
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1396102430Medicaid