MEDICARE: BRENNAN BEHAVIORAL HEALTH, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1881281319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRENNAN BEHAVIORAL HEALTH, INC

Provider Business Mailing Address
First Line	:	4 SOUTH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2956
Country	:	US
Telephone Number	:	774-451-3453
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 SOUTH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2956
Country	:	US
Telephone Number	:	774-451-3453
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MELISSA BRENNAN
Credential	:
Telephone Number	:	774-451-3453

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	12/30/2020

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