Healthcare Provider Details

I. General information

NPI: 1346476736
Provider Name (Legal Business Name): BRIAN CARBERG LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2009
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 E MAIN ST STE 4
AVON CT
06001-3832
US

IV. Provider business mailing address

19 E MAIN ST
AVON CT
06001-3832
US

V. Phone/Fax

Practice location:
  • Phone: 860-917-1927
  • Fax: 860-269-3700
Mailing address:
  • Phone: 860-917-1927
  • Fax: 860-269-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001537
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: