Healthcare Provider Details

I. General information

NPI: 1770185399
Provider Name (Legal Business Name): DANEEN BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 W LAKE MARY BLVD STE 208
LAKE MARY FL
32746-3460
US

IV. Provider business mailing address

417 COMMERCIAL CT STE C
VENICE FL
34292-1655
US

V. Phone/Fax

Practice location:
  • Phone: 813-364-2802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24684
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: