Provider Demographics
NPI:1184214827
Name:BRIGGS, WANDA P (LCMHC)
Entity Type:Individual
Prefix:DR
First Name:WANDA
Middle Name:P
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11722 MEETINGHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4565
Mailing Address - Country:US
Mailing Address - Phone:704-718-3781
Mailing Address - Fax:
Practice Address - Street 1:9820 NORTHCROSS CENTER CT
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7356
Practice Address - Country:US
Practice Address - Phone:704-718-3781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS4407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health