Healthcare Provider Details

I. General information

NPI: 1962193813
Provider Name (Legal Business Name): SAMAYA BRIZARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 FEDERAL ST
DANVERS MA
01923-3668
US

IV. Provider business mailing address

56 PRESCOTT ST
EVERETT MA
02149-1129
US

V. Phone/Fax

Practice location:
  • Phone: 781-307-0098
  • Fax:
Mailing address:
  • Phone: 781-521-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: