Healthcare Provider Details

I. General information

NPI: 1083781793
Provider Name (Legal Business Name): ANTHONY MICHAEL BRIGGS SR. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N SAINT ASAPH ST
ALEXANDRIA VA
22314-1912
US

IV. Provider business mailing address

720 N SAINT ASAPH ST
ALEXANDRIA VA
22314-1912
US

V. Phone/Fax

Practice location:
  • Phone: 703-838-6400
  • Fax: 703-519-3482
Mailing address:
  • Phone: 703-838-6400
  • Fax: 703-519-3482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701003696
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: