Provider Demographics
NPI:1912342775
Name:BRIGHTMAN, JAMES HOWARD (LICSW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HOWARD
Last Name:BRIGHTMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WALTHAM ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-8033
Mailing Address - Country:US
Mailing Address - Phone:781-862-3600
Mailing Address - Fax:781-863-5903
Practice Address - Street 1:1040 WALTHAM ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-8033
Practice Address - Country:US
Practice Address - Phone:781-862-3600
Practice Address - Fax:781-863-5903
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18633OtherBCBS
MA0000023532OtherBMC
MA99618201OtherNETWORK HEALTH
MA042611055OtherTAX ID
MA1303287OtherMBHP
MA1303287Medicaid
MA1004745OtherNHP