Provider Demographics
NPI:1851635544
Name:BRISKIN, STEPHANIE GAIL (MS LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GAIL
Last Name:BRISKIN
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SIMPSON RD
Mailing Address - Street 2:SUITE 109-B
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9689
Mailing Address - Country:US
Mailing Address - Phone:724-785-9444
Mailing Address - Fax:724-785-9458
Practice Address - Street 1:129 SIMPSON RD
Practice Address - Street 2:SUITE 109-B
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9689
Practice Address - Country:US
Practice Address - Phone:724-785-9444
Practice Address - Fax:724-785-9458
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006642101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional