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NPI Code Detail

MEDICARE: NATHANIEL WINFIELD BRIGGS LPC-INTERN

MEDICARE: NATHANIEL WINFIELD BRIGGS LPC-INTERN
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
1101YM0800XMental Health Counselor78839TX

General Provider Information

NPI Number : 1730645185
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL WINFIELD BRIGGS LPC-INTERN
Provider Business Mailing Address
First Line : 8338 GARRETT DR
Second Line :
City : TYLER
State : TX
Zip : 75703-5564
Country : US
Telephone Number : 214-598-6966
Fax Number :
Provider Business Practice Location Address
First Line : 7925 S BROADWAY AVE STE 820
Second Line :
City : TYLER
State : TX
Zip : 75703-5255
Country : US
Telephone Number : 903-561-8955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2019
Last Update Date : 02/11/2019

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Directions to “ NATHANIEL WINFIELD BRIGGS LPC-INTERN” Practice Location

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