Brissett, Michael James

Brissett, Michael James is an individual health care provider with primary practice located at 620 Hillcrest Rd Nw Suite 300, Lilburn GA 30047-1709. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Brissett, Michael James can be contacted via phone (770) 638-1577.

Contact Information

Primary practice address
620 Hillcrest Rd Nw Suite 300 Lilburn GA 30047-1709
Phone: (770) 638-1577
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 000558 Georgia

Profile Details

NPI number 1407914773
LBN Legal business name Brissett, Michael James
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Jul 18th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407914773 NPPES
Georgia MEDICAID 00494205C

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