Provider Demographics
NPI:1114582186
Name:BRIGGS, CHARLOTTE LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:LYNN
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CORE WELL HEALTH SCHOOL BASED CLINIC-DEPSA
Mailing Address - Street 2:1903 WILKINS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207
Mailing Address - Country:US
Mailing Address - Phone:947-519-8280
Mailing Address - Fax:313-782-4617
Practice Address - Street 1:CORE WELL HEALTH SCHOOL BASED CLINIC-DEPSA
Practice Address - Street 2:1903 WILKINS
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207
Practice Address - Country:US
Practice Address - Phone:947-519-8280
Practice Address - Fax:313-782-4617
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2024-02-20
Deactivation Date:2021-05-28
Deactivation Code:
Reactivation Date:2024-02-20
Provider Licenses
StateLicense IDTaxonomies
MI68010795991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical