Provider Demographics
NPI:1992169445
Name:VANTERPOOL, BRITTINY N INGRAM (LPCA)
Entity type:Individual
Prefix:MRS
First Name:BRITTINY
Middle Name:N INGRAM
Last Name:VANTERPOOL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:BRITTINY
Other - Middle Name:NICOLE
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:250 BRANCHVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025
Mailing Address - Country:US
Mailing Address - Phone:704-806-0952
Mailing Address - Fax:
Practice Address - Street 1:250 BRANCHVIEW DR SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025
Practice Address - Country:US
Practice Address - Phone:704-806-0952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health