Provider Demographics
NPI:1558376806
Name:BRIGGS, MARTY (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARTY
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 HARBOR LN NW
Mailing Address - Street 2:
Mailing Address - City:SUGAR VALLEY
Mailing Address - State:GA
Mailing Address - Zip Code:30746-5004
Mailing Address - Country:US
Mailing Address - Phone:706-629-0373
Mailing Address - Fax:
Practice Address - Street 1:190 CURTIS PKWY NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2062
Practice Address - Country:US
Practice Address - Phone:706-602-4484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional