Provider Demographics
NPI:1962777615
Name:BRISCOE, MAISHA JAHKEELA (MA, LCAS-P)
Entity type:Individual
Prefix:MS
First Name:MAISHA
Middle Name:JAHKEELA
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:MA, LCAS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S FAYETTEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-6404
Mailing Address - Country:US
Mailing Address - Phone:919-791-8949
Mailing Address - Fax:
Practice Address - Street 1:600 S FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6404
Practice Address - Country:US
Practice Address - Phone:919-791-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)