Nancy Brisebois-Good, LCPC, NCC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

LC5171 Issued in MD

Practice address

6131 Executive Blvd
Rockville, MD 20852-3901

Phone

(240) 205-9700

NPI assigned

Oct 26, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1619489960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13238 EXECUTIVE PARK TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742640",
            "telephone_number": "240-205-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 EXECUTIVE BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523901",
            "telephone_number": "240-205-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISEBOIS-GOOD",
        "first_name": "NANCY",
        "credential": "LCPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "LC5171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Group Psychotherapy Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.