Healthcare Provider Details

I. General information

NPI: 1265149975
Provider Name (Legal Business Name): BRIANNA KIERSTIN JOSEPHINE WILLIFORD-BUONICONTI DHSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 SPRINGFIELD ST
FEEDING HILLS MA
01030-2131
US

IV. Provider business mailing address

634 SPRINGFIELD ST
FEEDING HILLS MA
01030-2131
US

V. Phone/Fax

Practice location:
  • Phone: 413-225-1682
  • Fax:
Mailing address:
  • Phone: 413-225-1682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10003720
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10003720
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10003720
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: