Provider Demographics
NPI:1972068112
Name:WHARTON, BRITTANY (LCSW, LCAS-A)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WHARTON
Suffix:
Gender:F
Credentials:LCSW, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 YELLOW RIBBON DR APT U
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-3129
Mailing Address - Country:US
Mailing Address - Phone:910-258-2063
Mailing Address - Fax:
Practice Address - Street 1:1485 YELLOW RIBBON DR APT Q
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-3129
Practice Address - Country:US
Practice Address - Phone:910-258-2063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24810101YA0400X
NCP0124451041C0700X
NCC0132141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)