1154877389 NPI number — DR. BRITTANY JOY POPE L.P.C., PSYD

Table of content: DR. BRITTANY JOY POPE L.P.C., PSYD (NPI 1154877389)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154877389 NPI number — DR. BRITTANY JOY POPE L.P.C., PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POPE
Provider First Name:
BRITTANY
Provider Middle Name:
JOY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
L.P.C., PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154877389
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 124
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHEL
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45106-0124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-204-0630
Provider Business Mailing Address Fax Number:
907-290-2513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1022 DUNTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KETCHIKAN
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99901-6107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-204-0630
Provider Business Practice Location Address Fax Number:
907-290-2513
Provider Enumeration Date:
08/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  113884 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 216818 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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