Provider Demographics
NPI:1134355837
Name:BRIGGS, ELIZABETH M (LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 WOODBINE ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1922
Mailing Address - Country:US
Mailing Address - Phone:401-301-5638
Mailing Address - Fax:
Practice Address - Street 1:261 WICKENDEN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4422
Practice Address - Country:US
Practice Address - Phone:401-301-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235942Medicaid