Provider Demographics
NPI:1568690154
Name:BRIGGS, MARCIA ANN (PSYD, HSPP)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ANN
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 VALPARAISO ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3138
Mailing Address - Country:US
Mailing Address - Phone:219-477-5646
Mailing Address - Fax:
Practice Address - Street 1:2004 VALPARAISO ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3138
Practice Address - Country:US
Practice Address - Phone:219-477-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN20042608A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health