Healthcare Provider Details

I. General information

NPI: 1831507425
Provider Name (Legal Business Name): BRIGET ANTOINETTE EVANS L.I.C.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2014
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 VFW PKWY
CHESTNUT HILL MA
02467-3656
US

IV. Provider business mailing address

675 VFW PKWY
CHESTNUT HILL MA
02467-3656
US

V. Phone/Fax

Practice location:
  • Phone: 617-771-0275
  • Fax: 617-326-3360
Mailing address:
  • Phone: 617-771-0275
  • Fax: 617-326-3360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113136
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: