Provider Demographics
NPI:1588869689
Name:TESSIER, BRIAN ANTHONY (LCSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANTHONY
Last Name:TESSIER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2560
Mailing Address - Country:US
Mailing Address - Phone:203-296-3002
Mailing Address - Fax:203-303-9028
Practice Address - Street 1:326 W MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2560
Practice Address - Country:US
Practice Address - Phone:203-296-3002
Practice Address - Fax:203-303-9028
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0069861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235942Medicaid
CT004235942Medicaid