Provider Demographics
NPI:1730645185
Name:BRIGGS, NATHANIEL WINFIELD (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:WINFIELD
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 GARRETT DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5564
Mailing Address - Country:US
Mailing Address - Phone:214-598-6966
Mailing Address - Fax:
Practice Address - Street 1:7925 S BROADWAY AVE STE 820
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5255
Practice Address - Country:US
Practice Address - Phone:903-561-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health