Healthcare Provider Details

I. General information

NPI: 1447916531
Provider Name (Legal Business Name): LINDA CAMPBELL BRIERTY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 EDDY RD
BARKHAMSTED CT
06063-3355
US

IV. Provider business mailing address

46 EDDY RD
BARKHAMSTED CT
06063-3355
US

V. Phone/Fax

Practice location:
  • Phone: 917-957-4387
  • Fax:
Mailing address:
  • Phone: 917-957-4387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number052611
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: