Eriksson Brioso

Individual provider Active NPI Mental Health Counselor · Mount Shasta, CA

NPI 1114479797 · NPPES record last updated Oct 28, 2016

Key facts

NPI
1114479797
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
301 Chestnut St
Mount Shasta, CA 96067-2214
Phone
(530) 926-1436
Fax
(530) 926-2305
NPI assigned
Oct 28, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

301 Chestnut St
Mount Shasta, CA 96067-2214

Mailing address

301 Chestnut St
Mount Shasta, CA 96067-2214
Phone (530) 926-1436

Other providers in Mount Shasta, CA

All providers in Mount Shasta, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.