Provider Demographics
NPI:1548536402
Name:THERESA BRITTON, LMSW / FAMILY MATTERS COUNSELING
Entity type:Organization
Organization Name:THERESA BRITTON, LMSW / FAMILY MATTERS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-324-8000
Mailing Address - Street 1:576 ROMENCE RD
Mailing Address - Street 2:SUITE 227
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024
Mailing Address - Country:US
Mailing Address - Phone:269-324-8000
Mailing Address - Fax:
Practice Address - Street 1:576 ROMENCE RD
Practice Address - Street 2:SUITE 227
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-3472
Practice Address - Country:US
Practice Address - Phone:269-324-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010789751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003022914Medicaid