Provider Demographics
NPI:1992784581
Name:DELANEY, BRIAN L (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:L
Last Name:DELANEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CHESTER RD
Mailing Address - Street 2:2
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2805
Mailing Address - Country:US
Mailing Address - Phone:617-632-4206
Mailing Address - Fax:
Practice Address - Street 1:402 HIGHLAND AVE
Practice Address - Street 2:J
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2548
Practice Address - Country:US
Practice Address - Phone:617-429-0714
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8085103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical