Provider Demographics
NPI:1114475639
Name:BRIGGS, JANE (LMSWC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LMSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 PARK ROW
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2053
Mailing Address - Country:US
Mailing Address - Phone:207-370-2665
Mailing Address - Fax:
Practice Address - Street 1:153 PARK ROW
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2053
Practice Address - Country:US
Practice Address - Phone:207-370-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC15655101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor