1679689699 NPI number — MR. PAUL C. BRIGGS MSW,LCSW,LICSW,LMT

Table of content: (NPI 1053984807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679689699 NPI number — MR. PAUL C. BRIGGS MSW,LCSW,LICSW,LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRIGGS
Provider First Name:
PAUL
Provider Middle Name:
C.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW,LCSW,LICSW,LMT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679689699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6717 RALEIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33024-2807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-310-4591
Provider Business Mailing Address Fax Number:
754-263-5929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6717 RALEIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-2807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-310-4591
Provider Business Practice Location Address Fax Number:
754-263-5929
Provider Enumeration Date:
08/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C003436 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 110348 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225700000X , with the licence number: MA34970 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225700000X , with the licence number: NCTMB 308956-00 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: SW 5478 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110348 . This is a "COMMONWEATH OF MASSACHUSETTS BOARD OF REGISTRATION OF SOCIAL WORKERS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MA34970 . This is a "FLORIDA BOARD OF MASSAGE THERAPY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: SW5478 . This is a "FLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY AND MENTAL HEAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: C003436 . This is a "NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".