Healthcare Provider Details

I. General information

NPI: 1811287592
Provider Name (Legal Business Name): JASON BRIGGS LMHC, CASAC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2287 STATE ROUTE 21
CANANDAIGUA NY
14424-8837
US

IV. Provider business mailing address

2287 STATE ROUTE 21
CANANDAIGUA NY
14424-8837
US

V. Phone/Fax

Practice location:
  • Phone: 561-843-9498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22047
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005386
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number669294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: