Provider Demographics
NPI:1316250020
Name:BIRAN, AMI (MED, CAGS)
Entity type:Individual
Prefix:MRS
First Name:AMI
Middle Name:
Last Name:BIRAN
Suffix:
Gender:F
Credentials:MED, CAGS
Other - Prefix:MS
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CAGS
Mailing Address - Street 1:79 FOUNDRY RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2879
Mailing Address - Country:US
Mailing Address - Phone:781-784-1855
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-823-5400
Practice Address - Fax:508-880-8976
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA322623103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool