Provider Demographics
NPI:1205072402
Name:BRILEY, ANNTOINETTE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:ANNTOINETTE
Middle Name:
Last Name:BRILEY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BROOKSTONE CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-9246
Mailing Address - Country:US
Mailing Address - Phone:706-653-2889
Mailing Address - Fax:706-494-8220
Practice Address - Street 1:820 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9246
Practice Address - Country:US
Practice Address - Phone:706-653-2889
Practice Address - Fax:706-494-8220
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional