Provider Demographics
NPI:1386051274
Name:CARBONE, BRIANA MARGARET (BACHELOR OF SCIENCE)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARGARET
Last Name:CARBONE
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRENDA DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 CONSTITUTION LN STE 3B2
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3627
Practice Address - Country:US
Practice Address - Phone:413-579-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-13
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1219421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical