Provider Demographics
NPI:1538304126
Name:BRITZ, DIANE RENE (LCSW,MSW,BA)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:RENE
Last Name:BRITZ
Suffix:
Gender:F
Credentials:LCSW,MSW,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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:910-343-0145
Mailing Address - Fax:910-341-5779
Practice Address - Street 1:615 SHIPYARD BLVD.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6431
Practice Address - Country:US
Practice Address - Phone:910-343-0145
Practice Address - Fax:910-341-5779
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063651041C0700X
NCC0101531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherUBH/CONNECTICARE WELLMORE GRP/FACILITY
CT00802743Medicaid
CT060669107OtherUBH/ OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT539515OtherMHN MANAGED HEALTH NETWORK
CTD339123 141 E MAINOtherBEACON HEALTH STRATEGIES
CT4970561OtherCIGNA BEHAVIORAL HEALTH
CT539515 PENDINGOtherMHN TRICARE NORTH
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT9641730OtherAETNA BEHAVIORAL HEALTH
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT12754691OtherCAQH
CT539515 PENDINGOtherMHN TRICARE NORTH