Provider Demographics
NPI:1972118909
Name:TYER, BRITTANY MCKEON (LCSWA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MCKEON
Last Name:TYER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:COLE
Other - Last Name:MCKEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 DR MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4544
Practice Address - Country:US
Practice Address - Phone:910-343-0145
Practice Address - Fax:910-202-9966
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0150571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical