| Amia C. Briscoe Ma, Lpc | |
|
213 Patton Dr Ste A Shelby NC 28150-4696 | |
| (704) 466-3022 | |
| (844) 272-6196 |
| Full Name | Amia C. Briscoe Ma, Lpc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 213 Patton Dr Ste A, Shelby, North Carolina |
| Authorized Official Name and Position | Amia Chinon Briscoe (OUTPATIENT THERAPIST) |
| Authorized Official Contact | 7044663022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amia C. Briscoe Ma, Lpc 213 Patton Dr Ste A Shelby NC 28150-4696 Ph: (704) 466-3022 | Amia C. Briscoe Ma, Lpc 213 Patton Dr Ste A Shelby NC 28150-4696 Ph: (704) 466-3022 |
| NPI Number | 1730697475 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 04/14/2021 |
| Certification Date | 04/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730697475 | NPI | - | NPPES |
| 1730697475 | Medicaid | NC | |
| 1255753281 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | 9869 (North Carolina) | Secondary |
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