Provider Demographics
NPI:1699459057
Name:DAVIS, BRITTANY (CASAC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1019
Mailing Address - Country:US
Mailing Address - Phone:607-832-5888
Mailing Address - Fax:607-832-6081
Practice Address - Street 1:243 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1019
Practice Address - Country:US
Practice Address - Phone:607-832-5888
Practice Address - Fax:607-832-6081
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35412101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)