Provider Demographics
NPI:1053642199
Name:BRIGGS, ADAM MATTHEW (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MATTHEW
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-3368
Mailing Address - Country:US
Mailing Address - Phone:248-506-6881
Mailing Address - Fax:
Practice Address - Street 1:1208 PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-3368
Practice Address - Country:US
Practice Address - Phone:248-506-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-09-5896103K00000X
KS1-09-5896103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst