Provider Demographics
NPI:1699251892
Name:BERTRAND, JOSEPH JR
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:BERTRAND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2641
Mailing Address - Country:US
Mailing Address - Phone:508-983-4805
Mailing Address - Fax:
Practice Address - Street 1:233 NEEDHAM ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1573
Practice Address - Country:US
Practice Address - Phone:774-203-4671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health