Healthcare Provider Details

I. General information

NPI: 1962284596
Provider Name (Legal Business Name): JIMEARIA LAESHUN BRIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 N 18TH ST STE 210
MONROE LA
71201-5462
US

IV. Provider business mailing address

304 ASHLEY AVE APT 19
RAYVILLE LA
71269-3441
US

V. Phone/Fax

Practice location:
  • Phone: 318-503-8553
  • Fax:
Mailing address:
  • Phone: 337-448-5818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: