Provider Demographics
NPI:1962568535
Name:COUTURE, BRIAN JOSEPH (MA)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:COUTURE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2603
Mailing Address - Country:US
Mailing Address - Phone:415-777-0333
Mailing Address - Fax:415-864-4065
Practice Address - Street 1:141 LELAND AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-2847
Practice Address - Country:US
Practice Address - Phone:415-508-3872
Practice Address - Fax:415-508-4015
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor