Provider Demographics
NPI:1679689699
Name:BRIGGS, PAUL C (MSW, LCSW, LMT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:C
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:MSW, LCSW, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2807
Mailing Address - Country:US
Mailing Address - Phone:305-310-4591
Mailing Address - Fax:754-263-5929
Practice Address - Street 1:2750 N 29TH AVE STE 313
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-1519
Practice Address - Country:US
Practice Address - Phone:305-310-4591
Practice Address - Fax:754-263-5929
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCTMB 308956-00225700000X
FLMA34970225700000X
FLSW 54781041C0700X
MA1103481041C0700X
NCC0034361041C0700X
FLMA 34970225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW5478OtherFLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL HEAL
MA110348OtherCOMMONWEATH OF MASSACHUSETTS BOARD OF REGISTRATION OF SOCIAL WORKERS
NCC003436OtherNORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
FLMA34970OtherFLORIDA BOARD OF MASSAGE THERAPY