MEDICARE: MR. STEVEN DRIGGS BRINTON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	SW1699	AZ

General Provider Information

NPI Number	:	1376711143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN DRIGGS BRINTON LCSW

Provider Business Mailing Address
First Line	:	2321 E. UNIVERSITY
Second Line	:	P.O. BOX 31256
City	:	MESA
State	:	AZ
Zip	:	85275
Country	:	US
Telephone Number	:	602-284-8439
Fax Number	:	480-835-1071

Provider Business Practice Location Address
First Line	:	2321 E UNIVERSITY DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-8384
Country	:	US
Telephone Number	:	602-284-8439
Fax Number	:	480-835-1071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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