Provider Demographics
NPI:1891235297
Name:FRIERSON-BRISCOE, RENEE DARCELL (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:DARCELL
Last Name:FRIERSON-BRISCOE
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 1:6030 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1901
Mailing Address - Country:US
Mailing Address - Phone:267-971-2615
Mailing Address - Fax:215-549-3093
Practice Address - Street 1:501 WASHINGTON LANE
Practice Address - Street 2:SUITE 200
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3145
Practice Address - Country:US
Practice Address - Phone:267-259-4141
Practice Address - Fax:215-277-7992
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health