Provider Demographics
NPI:1194954610
Name:BRISSON, MEREDITH (LICSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:BRISSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01756-1090
Mailing Address - Country:US
Mailing Address - Phone:413-552-8219
Mailing Address - Fax:508-473-1226
Practice Address - Street 1:31 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MA
Practice Address - Zip Code:01756-1090
Practice Address - Country:US
Practice Address - Phone:413-552-8219
Practice Address - Fax:508-473-1226
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical