Provider Demographics
NPI:1962947234
Name:BRIGGS, REGINALD (LCA-DC)
Entity type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:LCA-DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 ROLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5615
Mailing Address - Country:US
Mailing Address - Phone:240-777-4213
Mailing Address - Fax:
Practice Address - Street 1:981 ROLLINS AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-5615
Practice Address - Country:US
Practice Address - Phone:240-777-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA2280101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)