Provider Demographics
NPI:1073171559
Name:BIGGS, MARINA KINGSTON (LPCA)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:KINGSTON
Last Name:BIGGS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 TALL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9358
Mailing Address - Country:US
Mailing Address - Phone:203-314-0715
Mailing Address - Fax:
Practice Address - Street 1:515 TALL OAKS DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9358
Practice Address - Country:US
Practice Address - Phone:203-314-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14267101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor